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Early Vascular Response to Ultrathin Biodegradable Polymer Sirolimus-Eluting Stents for the Treatment of ST-Elevation Myocardial Infarction After Plaque Rupture
- Source :
- International Heart Journal. 62:42-49
- Publication Year :
- 2021
- Publisher :
- International Heart Journal (Japanese Heart Journal), 2021.
-
Abstract
- Recent clinical studies suggest that newer-generation drug-eluting stents that combine ultrathin struts and nanocoating (biodegradable polymer sirolimus-eluting stents, BP-SES) could improve long-term clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). However, the early vascular response to BP-SES in these patients has not been investigated so far.We examined this response in 20 patients with STEMI caused by plaque rupture using frequency-domain optical coherence tomography (OCT) to understand the underlying mechanisms. Plaque rupture was diagnosed by OCT before PCI with BP-SES implantation was performed. OCT was again performed before the final angiography (post-PCI) and after 2 weeks (2W-OCT).BP-SES placement caused protrusion of atherothrombotic material into the stent lumen and incomplete stent apposition in all patients. After 2 weeks, incomplete stent apposition was significantly reduced (% malapposed struts: post-PCI 4.7 ± 3.3%; 2W-OCT 0.9 ± 1.2%; P < 0.0001), and the percentage of uncovered struts also significantly decreased (% uncovered struts: post-PCI; 69.8 ± 18.3%: 2W-OCT; 29.6 ± 11.0%, P < 0.0001). The maximum protrusion area of the atherothrombotic burden was significantly reduced (post-PCI 1.36 ± 0.70 mm2; 2W-OCT 0.98 ± 0.55 mm2; P = 0.004).This study on the early vascular responses following BP-SES implantation showed rapid resolution of atherothrombotic material and progression of strut apposition and coverage. (UMIN000041324).
- Subjects :
- Male
medicine.medical_specialty
Acute coronary syndrome
medicine.medical_treatment
Lumen (anatomy)
Pilot Projects
030204 cardiovascular system & hematology
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Coronary Circulation
Internal medicine
medicine
Humans
Prospective Studies
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Aged
Sirolimus
Antibiotics, Antineoplastic
medicine.diagnostic_test
business.industry
Percutaneous coronary intervention
Stent
Drug-Eluting Stents
General Medicine
Middle Aged
equipment and supplies
medicine.disease
Coronary Vessels
Apposition
Treatment Outcome
surgical procedures, operative
Angiography
Conventional PCI
Cardiology
ST Elevation Myocardial Infarction
Female
Cardiology and Cardiovascular Medicine
business
Tomography, Optical Coherence
Subjects
Details
- ISSN :
- 13493299 and 13492365
- Volume :
- 62
- Database :
- OpenAIRE
- Journal :
- International Heart Journal
- Accession number :
- edsair.doi.dedup.....3e20563ec617cc9172a0dd54ed3fdac0