Optical coherence tomography assessment of the acute effects of stent implantation on the vessel wall: A systematic quantitative approach

N. Gonzalo, P. W. Serruys, T. Okamura, Z. J. Shen, Y. Onuma, H. M. Garcia-Garcia, G. Sarno, C. Schultz, R. J. Van Geuns, J. Ligthart, E. Regar

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151 Citations (Scopus)


Objective: To observe and characterise vessel injury after stenting using optical coherence tomography (OCT), to propose a systematic OCT classification for periprocedural vessel trauma, to evaluate its frequency in stable versus unstable patients and to assess its clinical impact during the hospitalisation period. Setting: Stenting causes vessel injury. Design and interventions: All consecutive patients in whom OCT was performed after stent implantation were included in the study. Qualitative and quantitative assessment of tissue prolapse, intra-stent dissection and edge dissection were performed. Results: Seventy-three patients (80 vessels) were analysed. Tissue prolapse within the stented segment was visible in 78/80 vessels (97.5%). Median number of tissue prolapse sites was 8 (IQR 4-19), mean (SD) area 1.04 (0.9) mm2. Intra-stent dissection flaps were visible in 69/80 vessels (86.3%) (median number 3 (IQR 1.25-6), maximum flap length 450 (220) μm). Fifty-five out of 80 vessels (68.8%) showed dissection cavities (median number 2 (IQR 0-4.75), maximum depth 340 (170) μm). Edge dissection was visible in 20 vessels (mean (SD) length flap 744 (439) μm). The frequency of tissue prolapse or intra-stent dissection was similar in stable and unstable patients (95.6% vs 100%, p = 0.5 for tissue prolapse; 91.1% vs 82.9%, p = 0.3 for intra-stent dissection). There were no events during the hospitalisation period. Conclusions: OCT allows a detailed visualisation of vessel injury after stent implantation and enables a systematic classification and quantification in vivo. In this study, frequency of tissue prolapse or intra-stent dissections after stenting was high, irrespective of the clinical presentation of the patients, and was not associated with clinical events during hospitalisation.

Original languageEnglish
Pages (from-to)1913-1919
Number of pages7
Issue number23
Publication statusPublished - 1 Dec 2009
Externally publishedYes


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