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  • Title: Intracoronary thrombus formation after drug-eluting stents implantation: optical coherence tomographic study.
    Author: Kim JS, Hong MK, Fan C, Kim TH, Shim JM, Park SM, Ko YG, Choi D, Jang Y.
    Journal: Am Heart J; 2010 Feb; 159(2):278-83. PubMed ID: 20152227.
    Abstract:
    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 > or =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 > or =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.
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