The use of optical coherence tomography imaging of the vascular wall of the coronary arteries before and after stenting

Introduction. Optical coherence tomography (OCT) is an intravascular imaging method that allows to evaluate the structure of the vascular wall, as well as to monitor the process of stent installation and healing. The aim of this work was to identify factors affecting neointimal vascular healing after implantation of drug­eluting stents. Material and methods. In 35 patients with acute coronary syndrome without ST elevation, everolimus­eluted stents with permanent and biodegradable polymer were installed. After 6 months patients underwent control coronary angiography with OCT, the state of neointima of previously implanted stents was analyzed. Clinical, anamnestic and laboratory parameters were evaluated. Results. 28750 struts of stents were analyzed and the healing score was calculated. The healing score depended on the patient’s age (r=0.60710, p=0.0003), a history of diabetes mellitus (p=0.0477), current myocardial infarction (p=0.0183), and the degree of coronary artery disease (p=0.0355). The healing score was signifcantly lower in patients with a Syntax score <22 (p=0.004). Conclusion. The results of the research showed that main factors that impair neointimal healing are age, the presence of diabetes, the characteristics of the lesion of the coronary arteries; they may affect the duration of dual antiplatelet therapy.