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- Title
Very late stent thrombosis related to incomplete neointimal coverage or neoatherosclerotic plaque rupture identified by optical coherence tomography imaging.
- Authors
Amabile, Nicolas; Souteyrand, Géraud; Ghostine, Said; Combaret, Nicolas; Slama, Michel S.; Barber-Chamoux, Nicolas; Motreff, Pascal; Caussin, Christophe
- Abstract
Aims Recent data have reported that neoatherosclerosis could develop long after stent implantation and lead to subsequent rupture and acute coronary syndrome (ACS). We sought to identify the presence of in-stent neoatheroma (ISNA) in patients with very late stent thrombosis (VLST) using optical coherence tomography (OCT). Methods and results All patients from two catheterization centres who presented with ACS related to VLST underwent a standard coronary angiography and intra-coronary OCT. ISNA was defined as the combination of diffuse neointimal proliferation, lipid-laden intima with plaque organization, and fibrous cap rupture with no evidence of an uncovered strut. Conclusion Our data show that ISNA is frequent in patients with VLST. These results suggest that OCT imaging is helpful in identifying the underlying mechanisms of VLST and, therefore, in the clinical decision-making process.
- Subjects
ATHEROSCLEROSIS; THROMBOSIS diagnosis; ACUTE coronary syndrome; ARTERIES; PATIENT selection; ANGIOGRAPHY; CARDIOLOGY; CHI-squared test; FISHER exact test; STATISTICS; SURGICAL stents; TOMOGRAPHY; U-statistics; DATA analysis; DATA analysis software; DIAGNOSIS; ANATOMY
- Publication
European Heart Journal - Cardiovascular Imaging, 2014, Vol 15, Issue 1, p24
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jet052