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Identification of post-procedural optical coherence tomography findings associated with the 1-year vascular response evaluated by coronary angioscopy

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Abstract

Optical coherence tomography (OCT) provides higher resolution intravascular imaging and allows detailed evaluations of stent implantation sites post-percutaneous coronary intervention (PCI). Coronary angioscopy (CAS) can evaluate the vascular response after drug-eluting stent (DES) implantation. The post-PCI OCT findings that are associated with the CAS 1-year vascular response have not been known. We enrolled 168 lesions from 119 patients who underwent OCT-guided PCI using DES and follow-up CAS observation at 1 ± 0.5 year from August 2012 to December 2019. Outcome measures were sufficient neointimal coverage (NIC) defined as stent struts embedded in the neointima, subclinical intrastent thrombus, and vulnerable stented segments defined as those with angioscopic yellow or intensive yellow color 1 year after PCI. We identified the post-PCI OCT findings associated with these CAS findings. Sufficient NIC, subclinical intrastent thrombus, and vulnerable stented segment were detected in 85 lesions (51%), 47 lesions (28%), and 54 lesions (32%), respectively. A multivariate analysis demonstrated that malapposed struts were negatively associated with sufficient NIC (odds ratio 0.87; 95% CI 0.76–0.99; p = 0.029). However, no specific OCT findings immediately after PCI were associated with subclinical intrastent thrombus or vulnerable stented segment. Malapposition immediately after PCI was negatively associated with sufficient NIC at 1 year even without associations between post-PCI OCT findings and subclinical intrastent thrombus or vulnerable stented segment.

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Data availability

Our study data will not be made available to other researchers for purposes of reproducing the results, due to institutional review board restrictions.

Abbreviations

CAS:

Coronary angioscopy

CRP:

C-reactive protein

DES:

Drug-eluting stent

ISA:

Incomplete stent apposition

LAD:

Left anterior descending

NIC:

Neointimal coverage

OCT:

Optical coherence tomography

PCI:

Percutaneous coronary intervention

SED:

Stent edge dissection

ST:

Stent thrombosis

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Authors and Affiliations

  1. Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan

    Naoko Higashino, Takayuki Ishihara, Osamu Iida, Takuya Tsujimura, Yosuke Hata, Taku Toyoshima, Sho Nakao & Toshiaki Mano

  2. Department of Clinical Engineering, Kansai Rosai Hospital, Amagasaki, Japan

    Naoya Kurata

Authors
  1. Naoko Higashino
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  2. Takayuki Ishihara
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  3. Osamu Iida
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  4. Takuya Tsujimura
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Correspondence to Takayuki Ishihara.

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Conflict of interest

O. Iida has received remuneration from Boston Scientific Japan. T. Mano has received a research grant from Abbott Medical Japan. The remaining authors have no disclosures to report.

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Name of the ethics committee: The Medical Ethics Committee of Kansai Rosai Hospital; Reference number: 18D060g.

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Higashino, N., Ishihara, T., Iida, O. et al. Identification of post-procedural optical coherence tomography findings associated with the 1-year vascular response evaluated by coronary angioscopy. Cardiovasc Interv and Ther 38, 86–95 (2023). https://doi.org/10.1007/s12928-022-00880-0

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