Incidental Finding of Strut Malapposition Is a Predictor of Late and Very Late Thrombosis in Coronary Bioresorbable Scaffolds

Boeder NF, Weissner M, Blachutzik F, Ullrich H, Anadol R, Tröbs M, Muenzel T, Hamm CW, Dijkstra J, Achenbach S, Nef HM, Gori T (2019)


Publication Type: Journal article

Publication year: 2019

Journal

Book Volume: 8

Journal Issue: 5

DOI: 10.3390/jcm8050580

Abstract

Malapposition is a common finding in stent and scaffold thrombosis (ScT). Evidence from studies with prospective follow-up, however, is scarce. We hypothesized that incidental observations of strut malapposition might be predictive of late ScT during subsequent follow-up. One hundred ninety-seven patients were enrolled in a multicentre registry with prospective follow-up. Optical coherence tomography (OCT), performed in an elective setting, was available in all at 353 (0-376) days after bioresorbable scaffold (BRS) implantation. Forty-four patients showed evidence of malapposition that was deemed not worthy of intervention. Malapposition was not associated with any clinical or procedural parameter except for a higher implantation pressure (p = 0.0008). OCT revealed that malapposition was associated with larger vessel size, less eccentricity (all p < 0.01), and a tendency for more uncovered struts (p = 0.06). Late or very late ScT was recorded in seven of these patients 293 (38-579) days after OCT. OCT-diagnosed malapposition was a predictor of late and very late scaffold thrombosis (p < 0.001) that was independent of the timing of diagnosis. We provide evidence that an incidental finding of malappositionregardless of the timing of diagnosis of the malappositionduring an elective exam is a predictor of late and very late ScT. Our data provide a rationale to consider prolonged dual antiplatelet therapy if strut malapposition is observed.

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APA:

Boeder, N.F., Weissner, M., Blachutzik, F., Ullrich, H., Anadol, R., Tröbs, M.,... Gori, T. (2019). Incidental Finding of Strut Malapposition Is a Predictor of Late and Very Late Thrombosis in Coronary Bioresorbable Scaffolds. Journal of Clinical Medicine, 8(5). https://dx.doi.org/10.3390/jcm8050580

MLA:

Boeder, Niklas F., et al. "Incidental Finding of Strut Malapposition Is a Predictor of Late and Very Late Thrombosis in Coronary Bioresorbable Scaffolds." Journal of Clinical Medicine 8.5 (2019).

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