Optical coherence tomography evaluation of drug-eluting stents: A systematic review

Aristotelis C. Papayannis, Daisha Cipher, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

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Abstract

Aims We performed a systematic review of studies reporting stent strut coverage and malapposition post implantation of different drug-eluting stent (DES), as assessed by optical coherence tomography (OCT). Methods A review of publications and online databases in May 2011 retrieved 33 published studies reporting stent strut coverage and malapposition post-DES implantation using OCT: 24 for sirolimus-eluting stents (SES), 13 for paclitaxel-eluting stents (PES), 10 for zotarolimus-eluting stents (ZES), and two for everolimus-eluting stents (EES). The follow-up duration ranged from 3 months to 4 years. Stent strut coverage and malapposition were compared between DES at various time intervals post implantation. Results Significant differences in stent strut coverage and malapposition exist between various DES. The SES had the highest frequency of uncovered struts at 3, 6, 9, and 12 months (13.1%, 10.9%, 8.1%, and 7.5%, respectively), followed by PES (5.5%, 4.4%, and 5.7% at 6, 9, and 12 months, respectively) and ZES (0.7%, 0%, and 0.5% at 3, 6, and 9 months, respectively) (P < 0.001 for all comparisons between stents). Only two studies reported 3.1% uncovered struts at 9 months with the EES. Stent strut malapposition at 6, 9, and 12 months was highest with SES (3.2%, 2.2%, and 1.2%, respectively) followed by PES (1.6%, 1.3%, and 0.9%, respectively), EES (0.46% at 9 months), and ZES (0.7% and 0.1% at 6 and 9 months, respectively). Conclusions SES had the highest rates of uncovered struts and malapposition, followed by PES and ZES. Such differences may explain the different clinical outcomes between various DES.

Original languageEnglish (US)
Pages (from-to)481-487
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume81
Issue number3
DOIs
StatePublished - Feb 2013

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Drug-Eluting Stents
Optical Coherence Tomography
Stents
Sirolimus
Paclitaxel

Keywords

  • coronary artery disease
  • optical coherence tomography
  • restenosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Optical coherence tomography evaluation of drug-eluting stents : A systematic review. / Papayannis, Aristotelis C.; Cipher, Daisha; Banerjee, Subhash; Brilakis, Emmanouil S.

In: Catheterization and Cardiovascular Interventions, Vol. 81, No. 3, 02.2013, p. 481-487.

Research output: Contribution to journalArticle

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abstract = "Aims We performed a systematic review of studies reporting stent strut coverage and malapposition post implantation of different drug-eluting stent (DES), as assessed by optical coherence tomography (OCT). Methods A review of publications and online databases in May 2011 retrieved 33 published studies reporting stent strut coverage and malapposition post-DES implantation using OCT: 24 for sirolimus-eluting stents (SES), 13 for paclitaxel-eluting stents (PES), 10 for zotarolimus-eluting stents (ZES), and two for everolimus-eluting stents (EES). The follow-up duration ranged from 3 months to 4 years. Stent strut coverage and malapposition were compared between DES at various time intervals post implantation. Results Significant differences in stent strut coverage and malapposition exist between various DES. The SES had the highest frequency of uncovered struts at 3, 6, 9, and 12 months (13.1{\%}, 10.9{\%}, 8.1{\%}, and 7.5{\%}, respectively), followed by PES (5.5{\%}, 4.4{\%}, and 5.7{\%} at 6, 9, and 12 months, respectively) and ZES (0.7{\%}, 0{\%}, and 0.5{\%} at 3, 6, and 9 months, respectively) (P < 0.001 for all comparisons between stents). Only two studies reported 3.1{\%} uncovered struts at 9 months with the EES. Stent strut malapposition at 6, 9, and 12 months was highest with SES (3.2{\%}, 2.2{\%}, and 1.2{\%}, respectively) followed by PES (1.6{\%}, 1.3{\%}, and 0.9{\%}, respectively), EES (0.46{\%} at 9 months), and ZES (0.7{\%} and 0.1{\%} at 6 and 9 months, respectively). Conclusions SES had the highest rates of uncovered struts and malapposition, followed by PES and ZES. Such differences may explain the different clinical outcomes between various DES.",
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AU - Banerjee, Subhash

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N2 - Aims We performed a systematic review of studies reporting stent strut coverage and malapposition post implantation of different drug-eluting stent (DES), as assessed by optical coherence tomography (OCT). Methods A review of publications and online databases in May 2011 retrieved 33 published studies reporting stent strut coverage and malapposition post-DES implantation using OCT: 24 for sirolimus-eluting stents (SES), 13 for paclitaxel-eluting stents (PES), 10 for zotarolimus-eluting stents (ZES), and two for everolimus-eluting stents (EES). The follow-up duration ranged from 3 months to 4 years. Stent strut coverage and malapposition were compared between DES at various time intervals post implantation. Results Significant differences in stent strut coverage and malapposition exist between various DES. The SES had the highest frequency of uncovered struts at 3, 6, 9, and 12 months (13.1%, 10.9%, 8.1%, and 7.5%, respectively), followed by PES (5.5%, 4.4%, and 5.7% at 6, 9, and 12 months, respectively) and ZES (0.7%, 0%, and 0.5% at 3, 6, and 9 months, respectively) (P < 0.001 for all comparisons between stents). Only two studies reported 3.1% uncovered struts at 9 months with the EES. Stent strut malapposition at 6, 9, and 12 months was highest with SES (3.2%, 2.2%, and 1.2%, respectively) followed by PES (1.6%, 1.3%, and 0.9%, respectively), EES (0.46% at 9 months), and ZES (0.7% and 0.1% at 6 and 9 months, respectively). Conclusions SES had the highest rates of uncovered struts and malapposition, followed by PES and ZES. Such differences may explain the different clinical outcomes between various DES.

AB - Aims We performed a systematic review of studies reporting stent strut coverage and malapposition post implantation of different drug-eluting stent (DES), as assessed by optical coherence tomography (OCT). Methods A review of publications and online databases in May 2011 retrieved 33 published studies reporting stent strut coverage and malapposition post-DES implantation using OCT: 24 for sirolimus-eluting stents (SES), 13 for paclitaxel-eluting stents (PES), 10 for zotarolimus-eluting stents (ZES), and two for everolimus-eluting stents (EES). The follow-up duration ranged from 3 months to 4 years. Stent strut coverage and malapposition were compared between DES at various time intervals post implantation. Results Significant differences in stent strut coverage and malapposition exist between various DES. The SES had the highest frequency of uncovered struts at 3, 6, 9, and 12 months (13.1%, 10.9%, 8.1%, and 7.5%, respectively), followed by PES (5.5%, 4.4%, and 5.7% at 6, 9, and 12 months, respectively) and ZES (0.7%, 0%, and 0.5% at 3, 6, and 9 months, respectively) (P < 0.001 for all comparisons between stents). Only two studies reported 3.1% uncovered struts at 9 months with the EES. Stent strut malapposition at 6, 9, and 12 months was highest with SES (3.2%, 2.2%, and 1.2%, respectively) followed by PES (1.6%, 1.3%, and 0.9%, respectively), EES (0.46% at 9 months), and ZES (0.7% and 0.1% at 6 and 9 months, respectively). Conclusions SES had the highest rates of uncovered struts and malapposition, followed by PES and ZES. Such differences may explain the different clinical outcomes between various DES.

KW - coronary artery disease

KW - optical coherence tomography

KW - restenosis

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