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

Abstract

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.

Pattern of Endothelialization in Left Atrial Appendage Occluder by Optic Coherence Tomography: A Pilot Study

“…By OCT, using near‐infrared light, 27 we could clearly see high‐resolution images of endothelium and metal struts (just like coronary stent struts). 10 , 27 , 28 OCT has been widely used to see the endothelialization process of coronary stent and incomplete endothelialization has been shown to be associated with stent thrombus. 29 Likewise, we believe this is the clearest way to see the surface of LAAO and help clinicians to determine whether antiplatelet or OAC should be resumed.…”

Ultra-thin everolimus-eluting stents in atherosclerotic lesions: Three years follow-up with subgroup analysis of ultra-long stents

“… 9 Moreover, the evaluation of the Tetrilimus EES (EverOCT study) demonstrated nearly complete endothelization and low neointimal hyperplasia accumulation at 3 and 6 months optical coherence tomography follow-up after implantation of Tetrilimus EES. 24 In the current study, we aimed to explore the long-term (3 years) safety and efficacy of Tetrilimus EES in the all-comers population, a less studied but significant clinical question.…”

Biochemical and electrochemical characterization of biofilms formed on everolimus-eluting coronary stents

“…DES are the most effective option in percutaneous coronary intervention while reducing restenosis [7,8]. However, stent implantation may cause other complications such as infection and thrombosis.…”