Drug-eluting stent implantation in patients with acute coronary syndrome - the Activity of Platelets after Inhibition and Cardiovascular Events: Optical Coherence Tomography (APICE OCT) study

Chieffo, Alaide; Parodi, Guido; Versaci, Francesco; Bianchi, R; Valenti, Renato; Saccà, Salvatore; Mongiardo, Annalisa; Span, Simonetta; Migliorini, Angela; Spaccarotella, Carmen; Reimers, Bernhard; Antoniucci, David; Indolfi, Ciro; Ferrari, Ângela; Maehara, Akiko; Mintz, Gary S.; Colombo, Antonio

doi:10.4244/eijy14m06_10

Cited by 9 publications

(6 citation statements)

References 29 publications

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“…Additionally, in the HEAL‐EES study, mean NIH thickness at 6 months follow‐up was 133.06 μm 22 . In contrast, the mean NIH thickness at 6 months was higher in the present study than some previously published studies (90 to 102 μm) 19,20,23 . Longer stent length and complex patient characteristics could possibly explain this disparity.…”

Section: Discussioncontrasting

confidence: 83%

Serial evaluation of vascular responses after implantation of everolimus‐eluting coronary stent by optical coherence tomography

Kaul

Abhyankar²,

Abhaichand

et al. 2021

Cathet Cardio Intervent

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Aim To evaluate healing response at strut‐level and cross‐section level after implanting an ultra‐thin strut, everolimus‐eluting stent with biodegradable polymer (Tetrilimus) using optical coherence tomography (OCT) at 3 and 6 months. Methods This was prospective, multi‐centre, single‐arm, and investigator‐initiated study performed at seven Indian sites between January, 2017 and September, 2018. OCT evaluations were performed in 57 patients who underwent Tetrilimus stent implantation. Follow‐up OCT was scheduled at 3 months for first 16 patients and at 6 months for 41 patients. Primary outcomes included degree of strut coverage, malapposition and thickness of neointimal hyperplasia (NIH) over covered struts. Results Sixty one Tetrilimus stents were implanted to treat 59 lesions in 57 patients. Paired (baseline and follow‐up) OCT data was available for 12 patients and 30 patients at 3 and 6 months, respectively. At 3 months, rapid early healing was indicated by 95.48% covered struts per lesion with very low (0.11 ± 0.06 mm) NIH. At 6 months, NIH accumulation was greater (0.21 ± 0.07 mm) as compared to 3 months. 99.77% of struts per lesion were covered at 6 months. There was a very symmetrical healing as shown by very low eccentricity index. There was no difference in vascular healing between stents with small to moderate size vessels (≤3.00 mm) and large size vessels (>3.00 mm). Conclusion Present study demonstrated nearly complete endothelization and low NIH accumulation at 3 and 6 months following implantation of ultra‐thin strut everolimus‐eluting biodegradable polymer‐coated Tetrilimus stent. Moreover, though being an ultra‐thin strut stent, there was no difference in vascular healing and eccentricity after implantation of the Tetrilimus stents with smaller and larger diameters.

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Section: Discussioncontrasting

confidence: 83%

Serial evaluation of vascular responses after implantation of everolimus‐eluting coronary stent by optical coherence tomography

Kaul

Abhyankar²,

Abhaichand

et al. 2021

Cathet Cardio Intervent

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“…Previous serial OCT studies of STEMI patients have mainly focused on the chronic phases between 6 and 15 months post-procedure [ 7 , 9 , 15 ]. Recently, Amabile et al investigated thrombus evolution during the very early phase (2–8 days after the onset) of acute coronary syndrome; however, the targeted lesions were treated without stenting [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Early vascular responses to everolimus-eluting cobalt–chromium stent in the culprit lesions of st-elevation myocardial infarction: results from a multicenter prospective optical coherence tomography study (MECHANISM-AMI 2-week follow-up study)

Morino

Terashita

Otake

et al. 2018

Cardiovasc Interv and Ther

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The use of cobalt-chromium everolimus-eluting stents (CoCr-EES) for ST-segment elevation myocardial infarction (STEMI) reduces the incidence of stent thrombosis compared with bare metal stents, and a substantial difference is apparent in the initial 2 weeks. However, vascular behavior during this early period remains unclear. This was a prospective study (MECH-ANISM-AMI-2W) to investigate early vascular responses in STEMI patients immediately after CoCr-EES implantation and at 2-week follow-up using frequency domain-optical coherence tomography (FD-OCT). The study enrolled 52 patients (age 63.7 ± 11.7 years, male 85.0%), of whom 44 patients were available for complete serial FD-OCT analyses. Both % uncovered struts and % malapposed struts were improved at 2-week follow-up (63 ± 20 vs. 21 ± 14%, p < 0.0001 and 7.3 ± 9.0 vs. 4.7 ± 5.9%, p = 0.005, respectively). Thrombus was decreased, with significant changes in longitudinal length to stent (28.8 ± 27.7 vs. 18.1 ± 20.2%, p = 0.0001) and maximal area (0.93 ± 0.84 vs. 0.65 ± 0.63 mm 2 , p = 0.034). As a result, the average lumen area was significantly larger at 2 weeks (6.49 ± 1.82 vs. 6.71 ± 1.89 mm 2 , p = 0.048, respectively). The number of dissection flaps was lower (0.86 ± 1.11 vs. 0.52 ± 0.90%, p = 0.024). In conclusion, this study showed early vascular responses to CoCr-EES for STEMI lesions-including a significant reduction of thrombus-that resulted in lumen enlargement, earlier progression of strut coverage, and improvements in strut apposition and dissection. The combination of these factors may therefore be responsible for the safety of CoCr-EES within the initial 2 weeks.

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“…With the assumption of an average Angiolite stent length of 20 mm, a mean number of eight struts per analyzed cross‐sectional frame, and a 0.5 mm stepping interval for OCT analysis, we estimated to have 8,000 analyzable struts for 3‐month analysis and a further 8,000 struts analyzable at 6‐month analysis if n = 75 patients were to be enrolled (25 patients and 50 patients scheduled for 3‐ and 6‐month OCT follow‐up, respectively). On the basis of the recent published OCT data evaluating stent healing characteristics , we empirically chosed to enroll 75 patients (potentially yielding 24,000 struts for analysis). Assuming a 20% loss to imaging follow‐up rate, we thus planned to enroll a minimum of 100 patients.…”

Section: Methodsmentioning

confidence: 99%

Three‐ and 6‐month optical coherence tomographic surveillance following percutaneous coronary intervention with the Angiolite® drug‐eluting stent: The ANCHOR study

Puri

Otaegui

Sabaté

et al. 2017

Cathet Cardio Intervent

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Drug-eluting stent implantation in patients with acute coronary syndrome - the Activity of Platelets after Inhibition and Cardiovascular Events: Optical Coherence Tomography (APICE OCT) study

Abstract: In our study, in patients presenting with ACS, both EES and ZES-R had low percentages of malapposed and uncovered stent struts at six-month OCT analysis.

Cited by 9 publications

References 29 publications

Serial evaluation of vascular responses after implantation of everolimus‐eluting coronary stent by optical coherence tomography

Serial evaluation of vascular responses after implantation of everolimus‐eluting coronary stent by optical coherence tomography

Early vascular responses to everolimus-eluting cobalt–chromium stent in the culprit lesions of st-elevation myocardial infarction: results from a multicenter prospective optical coherence tomography study (MECHANISM-AMI 2-week follow-up study)

Three‐ and 6‐month optical coherence tomographic surveillance following percutaneous coronary intervention with the Angiolite® drug‐eluting stent: The ANCHOR study

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