Intracoronary thrombus formation after drug-eluting stents implantation: Optical coherence tomographic study
Received 21 August 2009; accepted 25 November 2009.
Background
Intracoronary thrombus formation after drug-eluting stent (DES) implantation is not sufficiently evaluated.
Methods
Optical coherence tomography (OCT) was performed in 226 patients (total DES n = 244, sirolimus-eluting stent [SES] n = 95, paclitaxel-eluting stent [PES] n = 62, zotarolimus-eluting stent [ZES] n = 87) after implantation (mean 11 months, range 3-66 months). Using OCT, we investigated the incidence and determinants of intracoronary thrombus.
Results
Intracoronary thrombus was detected in 35 (14%) cases (27 SES [28%], 7 PES [11%], and 1 ZES [1%], P < .001) and was associated with longer stent, smaller stent diameter, and stents at bifurcation lesions. More uncovered stent struts (26 ± 23 vs 8 ± 17, P < .001) and malapposed stent struts (6 ± 14 vs 2 ± 6, P < .001) were also associated with intracoronary thrombus. Multiple logistic regression analysis found the following determinants of intracoronary thrombus: stent length ≥28 mm (odds ratio [OR] 7.31, 95% CI 1.79-29.86, P = .01), stent diameter <3.0 mm (OR 4.38, 95% CI 1.38-13.97, P = .01), and ≥8 uncovered struts in each stent (OR 3.29, 95% CI 1.07-10.17, P = .04).
Conclusions
Length, size, and types of DES may be more important than clinical factors in intracoronary thrombus formation after DES implantations.
Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea
Reprint requests: Myeong-Ki Hong, MD, PhD, Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul 120-752, South Korea.
ABSTRACT