Target lesion coronary calcification assessed by optical coherence tomography was significantly associated with reduced stent expansion of 2nd-generation drug-eluting stents (P=0.02).
Observational (n=44)
Does the extent of target lesion coronary calcification assessed by OCT predict stent expansion in de novo native coronary artery lesions treated with 2nd-generation DES?
Pre-stent assessment of coronary calcification using OCT can help predict the degree of stent expansion for 2nd-generation drug-eluting stents.
p-value: p=0.02
BACKGROUND: Stent underexpansion remains a concern as a cause of drug-eluting stent (DES) failure. Although coronary calcification is considered to be a contributing factor in stent underexpansion, previous intravascular ultrasound studies have failed to demonstrate this relationship. We investigated whether stent expansion could be predicted by coronary calcification as assessed by optical coherence tomography (OCT). METHODS AND RESULTS: We enrolled 51 de novo native coronary artery lesions treated by a single 2nd-generation DES (3 types). Prior to stent deployment, the arc and area of calcium at the target lesion were measured using OCT. After successful stent implantation, OCT imaging was repeated to assess minimal stent diameter and area (MSD and MSA). Stent expansion was defined as MSD (or MSA) divided by the values predicted by the manufacturers' compliance charts. Patients were divided into 4 groups according to the median values of the arc and area of calcium. Mean stent expansion was 73.3±8.7% for MSD and 65.2±12.0% for MSA. Stent expansion defined by MSD was significantly different among the 4 groups (P=0.02). A similar trend was observed for stent expansion defined by MSA (P=0.16). CONCLUSIONS: The extent of target lesion calcification as assessed by OCT may be an important determinant of the expansion of 2nd-generation DES.
Kobayashi et al. (Wed,) conducted a observational in Angina (n=44). 2nd-generation drug-eluting stents (DES) was evaluated on Stent expansion defined by minimal stent diameter (MSD) across 4 groups based on median arc and area of calcium (p=0.02). Target lesion coronary calcification assessed by optical coherence tomography was significantly associated with reduced stent expansion of 2nd-generation drug-eluting stents (P=0.02).