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MedWire News: Optimal coherence tomography (OCT) imaging can clearly visualize stent apposition and neointimal coverage of stent struts, researchers report in the journal Heart.
They add: "Incomplete strut apposition and lack of strut coverage occurred with a significantly higher frequency in sirolimus-eluting stent (SES) than in bare-metal stent (BMS)."
OCT is the optical analog to ultrasound, measuring the back-reflection of infrared light instead of sound waves, and high resolution is its greatest advantage, the authors explain.
Xing Chen and colleagues from the Beijing Electric Power Hospital in China used OCT to analyze the neointimal coverage of SES and BMS in 24 patients undergoing percutaneous coronary intervention.
Patients were divided in three groups. The short-term BMS group (BMS1) consisted of seven patients, who received eight BMS and were followed-up for 5-10 months; the long-term BMS group (BMS2) consisted of six patients with six BMS who were followed-up for 23-93 months; and the SES group consisted of 10 patients who received 13 SES and were followed-up for 6-12 months.
The total number of stent struts evaluated was 1465, 1242, and 2425 in the BMS1, BMS2, and SES groups, respectively.
Analysis of OCT images showed that in the SES group there were significantly less completely apposed struts than in the BMS1 and BMS2 groups (98% vs 100% and 100%, respectively, p<0.0001). Patients in the SES groups also had a lower percentage of covered stent struts (83.0% vs 99.7% and 99.7%, p<0.0001).
Furthermore, patients in the SES group had significantly lower mean maximal neointimal thickness (NIT) (0.12 vs 0.59 and 0.61 mm, p<0.0001) and minimal NIT (0.04 vs 0.20 and 0.22 mm, p<0.0001).
Chen and co-workers conclude: "These findings may explain the occurrence of late thrombosis in SES."
They suggest: "Enhanced surveillance of patients with SES may help avoid some of the late complications with SES."
