P5628Resolution of incomplete stent apposition in the early phase after stent implantation: serial optical coherence tomography analyses at 2-week and 4-month

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Shimoda ◽  
H Ando ◽  
H Takashima ◽  
K Waseda ◽  
S Sakurai ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Early Phase ◽  
Second Generation ◽  
Curve Analysis ◽  
Natural Course ◽  
Receiver Operating Curve ◽  
Optical Coherence ◽  
Roc Curve Analysis ◽  
Incomplete Stent Apposition

Abstract Background Previous optical coherence tomography (OCT) study demonstrated that the incomplete stent apposition (ISA) distance <355 μm immediately after an index procedure was the corresponding cut-off point for predicting the resolution of ISA at 8–12 months follow-up in the second-generation DES. However, the natural course of acute ISA in the earlier phase remains unknown. The aim of the present study is to evaluate the natural course of acute ISA in the early phase after second-generation everolimus-eluting stent (EES) using serial OCT analyses at 2-week and 4-month. Methods From the population of the ACS-OCT trial, we identified a total of 45 patients who successfully underwent serial OCT examinations at post-stenting, 2-week follow-up, and 4-month follow-up. The presence of ISA was assessed in the OCT images, and ISA distance was measured within the stented segment. The target site for OCT analysis was the cross-section at the proximal edge of implanted stent. Serial OCT images at post-stenting, 2-week follow-up and 4-month follow-up were reviewed side by side on the screen, and maximum ISA distance and cross-sectional ISA area were measured. Results Incomplete stent apposition was observed in all EES at post-stenting, and it was persistent in 37.8% at 2-week follow-up and 11.1% at 4-month follow-up. Maximum ISA distance was significantly decreased over time (post-stenting, 144±150mm; 2-week follow-up, 88±146mm; 4-month follow-up, 34±111mm). Receiver-operating curve analysis identified that the best cut-off value of OCT-estimated ISA distance at post-stenting for predicting persistent ISA at 2-week follow-up and 4-month follow-up was >140μm and >215μm, respectively. ROC curve analysis Conclusion ISA distance at post-stenting is an useful predictor for the resolution of ISA in the early phase after EES implantation.

Impact of procedural characteristics on coronary vessel wall healing following implantation of second-generation drug-eluting absorbable metal scaffold in patients with de novo coronary artery lesions: an optical coherence tomography analysis

2018 ◽  
Vol 20 (8) ◽  
pp. 916-924 ◽  
Author(s):  
Yuichi Ozaki ◽  
Hector M Garcia-Garcia ◽  
Alexandre Hideo-Kajita ◽  
Kayode O Kuku ◽  
Michael Haude ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Vessel Wall ◽  
Second Generation ◽  
De Novo ◽  
Healing Process ◽  
Side Branch ◽  
Optical Coherence ◽  
Drug Eluting

Abstract Aims  Second-generation drug-eluting absorbable metal scaffold (DREAMS 2G) is an alternative novel device for treating coronary lesions. However, the relationship between in-scaffold dimensions after implantation of DREAMS 2G and vessel healing and luminal results at follow-up is unknown. The aim of this study is, therefore, to investigate whether the expansion index after implantation of DREAMS 2G as assessed by optical coherence tomography (OCT) impacts late luminal status and healing of the vessel wall. Methods and results  This study comprises of a total 65 out of 123 patients who were enrolled in the BIOSOLVE-II trial. We assessed both qualitative and quantitative OCT findings and the expansion index of DREAMS 2G after implantation frame by frame using OCT. Expansion index was defined as minimum scaffold area/mean reference lumen area. The over-expansion group was also defined with expansion index >1.0. The total number of analysed frames at post-procedure and 6-month follow-up was 8243 and 8263 frames, respectively. At 6-month follow-up, in-scaffold healing was documented by the reduction of 82% in dissections, 93% in attached intra-luminal mass (ILM), 65% in non-attached ILM, and 76% in jailed side branch. The over-expansion group had significantly greater in-scaffold luminal volume loss (LVL) compared with the non-over-expansion group [over-expansion: 35.0 (18.5–52.1) mm3 vs. non-over-expansion: 21.0 (11.6–37.9) mm3, P = 0.039]. Conclusion  Excellent in vivo healing process after implantation of DREAMS 2G was observed at 6 months. We found that higher expansion indices were associated with higher in-scaffold LVL at 6 months assessed by OCT.

P5622Clinical significance of late-acquired malapposition observed by serial optical coherence tomography after second-generation drug eluting stents

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Nakamura ◽  
T Yonetsu ◽  
M Nakao ◽  
S Nakagama ◽  
T Niida ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Cross Sections ◽  
Second Generation ◽  
Target Lesion ◽  
Drug Eluting Stents ◽  
Optical Coherence ◽  
Very Late Stent Thrombosis ◽  
Kaplan Meier ◽  
Drug Eluting

Abstract Background Previous studies have demonstrated that the presence of late-acquired stent malapposition after stent implantation may be a risk of late and very late stent thrombosis and myocardial infarction, which is however still controversial. Purpose We sought to investigate the incidence and prognosis of late acquired stent malapposion after second-generation drug eluting stents (2G-DES) implantation. Methods A total of 199 lesions in 139 patients who underwent optical coherence tomography (OCT) at both immediately after implantation (Baseline) and 6–12 months after 2G-DES implantation (follow-up) were investigated. We excluded lesions with stent failure before follow-up examination. We evaluated presence or absence of malapposed strut at 1mm interval of OCT images and stents with one or more cross-sections with >30% malapposed strut was defined as stents with malapposition (MP), otherwise well-apposed (WA). We divided the lesions into 4 groups according to the presence of malapposition at baseline and follow-up; WA and WA, persistent well-apposed; MP and WA, resoloved malapposition; WA and MP, late acquired malapposition (LAMP); and MP and MP, persistent malapposition. We compared the target lesion failure (TLF) rate after follow-up examination among 4 groups with Kaplan–Meier analysis. Results Median follow-up period was 469 (IQR 71–1416) days. follow-up OCT examination was performed at median 9 months (IQR 7.6–10.5). There were no significant differences in patient's and procedural characteristics among the 4 groups. TLF rate in LAMP group was 12.0% and Kaplan–Meier analysis showed no significant differences among the 4 groups in TLF rate. TLF-free suvival curves (Kaplan-Meier) Conclusion LAMP was observed by OCT at 6–12 months in 12.0% of lesions after 2G-DES implantation, which was not associated with TLF at 5 years.

Abstract 13271: Incidence of Stent Complications detected by Optical Coherence Tomography and their Clinical Significance: One Year Follow up Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Tsunenari Soeda ◽  
Seung-Jung Park ◽  
Yangsoo Jang ◽  
Stephen Lee ◽  
Owen C Raffel ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Stent Thrombosis ◽  
Clinical Significance ◽  
Univariate Analysis ◽  
Optical Coherence ◽  
Reference Area ◽  
Incomplete Stent Apposition ◽  
Stent Type ◽  
Stent Complications

Introduction: Optical coherence tomography (OCT) was introduced to optimize percutaneous coronary intervention (PCI). Due to its unprecedented resolution, complications are frequently visualized. The exact incidence and clinical significance of these OCT detected complications are unknown. Object: The aims of this study were 1) to evaluate the incidence of acute stent complications by OCT, 2) to correlate these complications with clinical outcome at 1 year, and 3) to identify the OCT predictors for major adverse cardiac events (MACE) including death, acute myocardial infarction (AMI), stent thrombosis, and target lesion revascularizations (TLR). Methods and Results: A total of 409 patients with 473 drug eluting stents (DES) who had post stent OCT imaging were included in this study. The incidence of stent edge dissection was 36.4% and of intra stent dissection was 72.3%. Incomplete stent apposition was detected in 36.4% of stents. The incidence of smooth protrusion, fibrous flap or disrupted fibrous plaque, irregular protrusion and thrombus were 93.7%, 56.0%, 55.2%, and 33.4%, respectively. Minimal stent underexpansion defined by minimal stent area (MSA) < 1.0 of reference area and severe stent underexpansion defined by MSA< 0.8 of reference area were observed in 84.8% and 37.8% of stents. MACE occurred in 3.7% of cases at 1 year follow up. There was no death. AMI, stent thrombosis, and TLR occurred in 0.7%, 0.2%, and 3.2%. Univariate analysis showed small MSA (MSA< 5 mm2) and irregular protrusion were correlated with MACE at 1year follow up (P=0.003 and P=0.044). Following adjustment of stent edge dissection, incomplete stent apposition, irregular protrusion, small MSA, stent type, and clinical presentations, small MSA and irregular protrusion remain as independent predictors of MACE (P=0.004 and P=0.037). Conclusions: OCT-detected stent complication rate is high. Small MSA and irregular protrusion are independent predictors of MACE at 1 year.

Inner Retinal Morphology and Visual Outcomes in Idiopathic Epiretinal Membrane Surgery: A Retrospective Optical Coherence Tomography Study

2021 ◽  
pp. 247412642198961
Author(s):  
Ioannis S. Dimopoulos ◽  
Michael Dollin
Keyword(s):  
Optical Coherence Tomography ◽  
Epiretinal Membrane ◽  
Strong Predictor ◽  
Plexiform Layer ◽  
Inner Plexiform Layer ◽  
Optical Coherence ◽  
Visual Outcomes ◽  
Retinal Pathology

Purpose: Epiretinal membrane (ERM) is a common retinal finding for patients older than 50 years. Disorganization of the retinal inner layers (DRIL) has emerged as a novel predictor of poor visual acuity (VA) in eyes with inner retinal pathology. The aim of our study is to correlate preoperative DRIL with visual outcomes after ERM surgery. Methods: Medical records and optical coherence tomography (OCT) images of 81 pseudophakic patients who underwent treatment of idiopathic ERM were reviewed. Preoperative DRIL on OCT was correlated with VA at baseline and at 3 and 6 months after ERM surgery. DRIL was defined as the loss of distinction between the ganglion cell–inner plexiform layer complex, inner nuclear layer, and outer plexiform layer. DRIL severity was based on its extent within the central 2-mm region of a transfoveal B-scan (absent/mild: <one-third, severe: >one-third horizontal width). Results: Review of preoperative OCT showed severe DRIL in 41% and absent/mild DRIL in 59%. Severe DRIL was associated with worse baseline VA ( P < .001). Preoperative VA and DRIL status at baseline were both predictors of postoperative VA at follow-up time points ( P < .001). Severe DRIL was associated with significantly less improvement in VA at 6 months (–0.23 logMAR for absent/mild vs –0.14 for severe DRIL). Conclusions: Presence of severe preoperative DRIL correlates with worse baseline VA in patients with ERM and reduced VA improvement at 6 months. DRIL can be a strong predictor of long-term poor visual outcomes in ERM surgery.

scholarly journals The Use of Anterior-Segment Optical-Coherence Tomography for the Assessment of the Iridocorneal Angle and Its Alterations: Update and Current Evidence

2021 ◽  
Vol 10 (2) ◽  
pp. 231
Author(s):  
Giacinto Triolo ◽  
Piero Barboni ◽  
Giacomo Savini ◽  
Francesco De Gaetano ◽  
Gaspare Monaco ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Intraocular Pressure ◽  
Clinical Relevance ◽  
Anterior Segment ◽  
Angle Closure ◽  
Current Evidence ◽  
Optical Coherence ◽  
Iridocorneal Angle ◽  
Wide Range

The introduction of anterior-segment optical-coherence tomography (AS-OCT) has led to improved assessments of the anatomy of the iridocorneal-angle and diagnoses of several mechanisms of angle closure which often result in raised intraocular pressure (IOP). Continuous advancements in AS-OCT technology and software, along with an extensive research in the field, have resulted in a wide range of possible parameters that may be used to diagnose and follow up on patients with this spectrum of diseases. However, the clinical relevance of such variables needs to be explored thoroughly. The aim of the present review is to summarize the current evidence supporting the use of AS-OCT for the diagnosis and follow-up of several iridocorneal-angle and anterior-chamber alterations, focusing on the advantages and downsides of this technology.

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