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Clinical Predictors for Lack of Favorable Vascular Response to Statin Therapy in Patients With Coronary Artery Disease: A Serial Optical Coherence Tomography Study Optical coherence tomography versus intravascular ultrasound to evaluate coronary artery disease and percutaneous coronary intervention A Survey on Coronary Atherosclerotic Plaque Tissue Characterization in Intravascular Optical Coherence Tomography Assessment of the coronary calcification by optical coherence tomography Volumetric characterization of human coronary calcification by frequency-domain optical coherence tomography Covering our tracks – optical coherence tomography to assess vascular healing Intravascular optical coherence tomography Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation Uncovered Culprit Plaque Ruptures in Patients With ST-Segment Elevation Myocardial Infarction Assessed by Optical Coherence Tomography and Intravascular Ultrasound With iMap Optical coherence tomography and C-reactive protein in risk stratification of acute coronary syndromes

Clinical Trial2018 Apr 6;13(18):e2174-e2181.

JOURNAL:EuroIntervention. Article Link

Characteristics of stent thrombosis in bifurcation lesions analysed by optical coherence tomography

Bechiri MY, Souteyrand G, Lefèvre T et al. Keywords: bifurcation; OCT; stent thrombosis; late ST; VLST; ACS/NSTE-ACS;

ABSTRACT


AIMSThis work aimed to investigate a cohort of patients presenting with stent thrombosis (ST) explored by optical coherence tomography (OCT) to identify the underlying mechanical abnormalities in case of bifurcation lesions.


METHODS AND RESULTSThe PESTO study was a prospective national registry involving 29 French catheterisation facilities. Patients with acute coronary syndromes were prospectively screened for presence of definite ST and analysed by OCT after culprit lesion reopening. The cohort involved 120 subjects, including 21 patients (17.5% of the global PESTO group; median age: 62.6 yrs; 76% male) with bifurcation lesions. The clinical presentation was acute or subacute ST in 34%, late ST in 5% and very late ST in 62% of the patients. The main underlying mechanisms were strut malapposition in 33%, stent underexpansion in 19% and isolated strut uncoverage in 19% of the cases. The proximal main branch was involved in 71%, distal main branch in 52% and jailed side branch in 5% of the patients.

CONCLUSIONSIn this cohort, bifurcation lesions represented a limited number of all ST cases. Different sections of the bifurcation could be involved. Although the underlying mechanisms were various, strut malapposition was the most frequently observed cause.