OCT-based diagnosis, management, and predictors of recurrent stent failure: a cohort study
BackgroundStent failure (SF) is a complication of percutaneous coronary intervention (PCI).ObjectivesThis study aimed to assess the relationship of the optical coherence tomography (OCT) determined cause of SF with time since stent implantation, treatment, and outcome.MethodsThis retrospective study...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-05-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1565676/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850276162336456704 |
|---|---|
| author | Giacomo Maria Cioffi Giacomo Maria Cioffi Pablo Lamelas Pablo Lamelas Mariam Shenouda Jamie Halperin Francesca Goffredo Francesca Goffredo Brian Patrick McGrath Brian Patrick McGrath Norman Said Vega Servin Shamir R. Mehta Shamir R. Mehta Sanjit S. Jolly Sanjit S. Jolly J. D. Schwalm J. D. Schwalm Madhu K. Natarajan Madhu K. Natarajan Nicholas Valettas James L. Velianou Michael B. Tsang Natalia Pinilla-Echeverri Matthew G. Sibbald Matthew G. Sibbald Tej N. Sheth |
| author_facet | Giacomo Maria Cioffi Giacomo Maria Cioffi Pablo Lamelas Pablo Lamelas Mariam Shenouda Jamie Halperin Francesca Goffredo Francesca Goffredo Brian Patrick McGrath Brian Patrick McGrath Norman Said Vega Servin Shamir R. Mehta Shamir R. Mehta Sanjit S. Jolly Sanjit S. Jolly J. D. Schwalm J. D. Schwalm Madhu K. Natarajan Madhu K. Natarajan Nicholas Valettas James L. Velianou Michael B. Tsang Natalia Pinilla-Echeverri Matthew G. Sibbald Matthew G. Sibbald Tej N. Sheth |
| author_sort | Giacomo Maria Cioffi |
| collection | DOAJ |
| description | BackgroundStent failure (SF) is a complication of percutaneous coronary intervention (PCI).ObjectivesThis study aimed to assess the relationship of the optical coherence tomography (OCT) determined cause of SF with time since stent implantation, treatment, and outcome.MethodsThis retrospective study included patients who underwent an OCT evaluation for SF from January 2013 to July 2023. In-stent findings were evaluated on OCT including tissue proliferation, tissue type, underexpansion, thrombus, and multiple stent layers. The relationship between time to presentation, treatment, and outcome was assessed.ResultsOf the 309 patients who underwent an OCT-guided PCI for SF, tissue proliferation was present in 228 (74%) and absent in 81 (26%). Among patients with tissue proliferation, OCT commonly showed lipidic neointima (n = 122, 54%), thrombus (n = 81, 36%), and underexpansion (n = 71, 31%). In patients without tissue proliferation, OCT commonly identified underexpansion (n = 58, 72%), thrombus (n = 55, 68%), and uncovered struts (n = 37, 46%). The mean time to SF was 6.89 ± 5.88 years with tissue proliferation and 2.98 ± 3.75 years without (p < 0.001). Patients with tissue proliferation were more likely to be treated with repeat stenting (78% vs. 60%, p < 0.001). Lipidic neointimal tissue and >1 layer of stent were predictors of target SF recurrence during a median 3 years of follow-up.ConclusionIn a large series of OCT-guided treatments of SF, tissue proliferation was more common, occurred later after stent implantation, and was more likely to be treated with repeat stenting than no-tissue proliferation. Lipidic neointimal tissue and >1 layer of stent were significant predictors of target SF during follow-up. |
| format | Article |
| id | doaj-art-fd8dfb65f04a4068b0d76be1c4c010ae |
| institution | OA Journals |
| issn | 2297-055X |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj-art-fd8dfb65f04a4068b0d76be1c4c010ae2025-08-20T01:50:24ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-05-011210.3389/fcvm.2025.15656761565676OCT-based diagnosis, management, and predictors of recurrent stent failure: a cohort studyGiacomo Maria Cioffi0Giacomo Maria Cioffi1Pablo Lamelas2Pablo Lamelas3Mariam Shenouda4Jamie Halperin5Francesca Goffredo6Francesca Goffredo7Brian Patrick McGrath8Brian Patrick McGrath9Norman Said Vega Servin10Shamir R. Mehta11Shamir R. Mehta12Sanjit S. Jolly13Sanjit S. Jolly14J. D. Schwalm15J. D. Schwalm16Madhu K. Natarajan17Madhu K. Natarajan18Nicholas Valettas19James L. Velianou20Michael B. Tsang21Natalia Pinilla-Echeverri22Matthew G. Sibbald23Matthew G. Sibbald24Tej N. Sheth25Division of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaDepartment of Cardiology, University and Hospital of Fribourg, Fribourg, SwitzerlandHealth Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, CanadaDepartment of Cardiology, Fundacion Favaloro, Buenos Aires, ArgentinaSchool of Medicine, McMaster University, Hamilton, ON, CanadaSchool of Medicine, McMaster University, Hamilton, ON, CanadaPopulation Health Research Institute (PHRI), McMaster University, Hamilton, ON, CanadaDepartment of Anesthesiology, University and Hospital of Fribourg, Fribourg, SwitzerlandDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaPopulation Health Research Institute (PHRI), McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaPopulation Health Research Institute (PHRI), McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaPopulation Health Research Institute (PHRI), McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaPopulation Health Research Institute (PHRI), McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaPopulation Health Research Institute (PHRI), McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaSchool of Medicine, McMaster University, Hamilton, ON, CanadaDivision of Cardiology, Hamilton General Hospital, Hamilton Health Sciences, McMaster University, Hamilton, ON, CanadaBackgroundStent failure (SF) is a complication of percutaneous coronary intervention (PCI).ObjectivesThis study aimed to assess the relationship of the optical coherence tomography (OCT) determined cause of SF with time since stent implantation, treatment, and outcome.MethodsThis retrospective study included patients who underwent an OCT evaluation for SF from January 2013 to July 2023. In-stent findings were evaluated on OCT including tissue proliferation, tissue type, underexpansion, thrombus, and multiple stent layers. The relationship between time to presentation, treatment, and outcome was assessed.ResultsOf the 309 patients who underwent an OCT-guided PCI for SF, tissue proliferation was present in 228 (74%) and absent in 81 (26%). Among patients with tissue proliferation, OCT commonly showed lipidic neointima (n = 122, 54%), thrombus (n = 81, 36%), and underexpansion (n = 71, 31%). In patients without tissue proliferation, OCT commonly identified underexpansion (n = 58, 72%), thrombus (n = 55, 68%), and uncovered struts (n = 37, 46%). The mean time to SF was 6.89 ± 5.88 years with tissue proliferation and 2.98 ± 3.75 years without (p < 0.001). Patients with tissue proliferation were more likely to be treated with repeat stenting (78% vs. 60%, p < 0.001). Lipidic neointimal tissue and >1 layer of stent were predictors of target SF recurrence during a median 3 years of follow-up.ConclusionIn a large series of OCT-guided treatments of SF, tissue proliferation was more common, occurred later after stent implantation, and was more likely to be treated with repeat stenting than no-tissue proliferation. Lipidic neointimal tissue and >1 layer of stent were significant predictors of target SF during follow-up.https://www.frontiersin.org/articles/10.3389/fcvm.2025.1565676/fulloptical coherence tomographystent failurein-stent restenosisstent thrombosisintracoronary imaging |
| spellingShingle | Giacomo Maria Cioffi Giacomo Maria Cioffi Pablo Lamelas Pablo Lamelas Mariam Shenouda Jamie Halperin Francesca Goffredo Francesca Goffredo Brian Patrick McGrath Brian Patrick McGrath Norman Said Vega Servin Shamir R. Mehta Shamir R. Mehta Sanjit S. Jolly Sanjit S. Jolly J. D. Schwalm J. D. Schwalm Madhu K. Natarajan Madhu K. Natarajan Nicholas Valettas James L. Velianou Michael B. Tsang Natalia Pinilla-Echeverri Matthew G. Sibbald Matthew G. Sibbald Tej N. Sheth OCT-based diagnosis, management, and predictors of recurrent stent failure: a cohort study Frontiers in Cardiovascular Medicine optical coherence tomography stent failure in-stent restenosis stent thrombosis intracoronary imaging |
| title | OCT-based diagnosis, management, and predictors of recurrent stent failure: a cohort study |
| title_full | OCT-based diagnosis, management, and predictors of recurrent stent failure: a cohort study |
| title_fullStr | OCT-based diagnosis, management, and predictors of recurrent stent failure: a cohort study |
| title_full_unstemmed | OCT-based diagnosis, management, and predictors of recurrent stent failure: a cohort study |
| title_short | OCT-based diagnosis, management, and predictors of recurrent stent failure: a cohort study |
| title_sort | oct based diagnosis management and predictors of recurrent stent failure a cohort study |
| topic | optical coherence tomography stent failure in-stent restenosis stent thrombosis intracoronary imaging |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2025.1565676/full |
| work_keys_str_mv | AT giacomomariacioffi octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT giacomomariacioffi octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT pablolamelas octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT pablolamelas octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT mariamshenouda octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT jamiehalperin octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT francescagoffredo octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT francescagoffredo octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT brianpatrickmcgrath octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT brianpatrickmcgrath octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT normansaidvegaservin octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT shamirrmehta octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT shamirrmehta octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT sanjitsjolly octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT sanjitsjolly octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT jdschwalm octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT jdschwalm octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT madhuknatarajan octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT madhuknatarajan octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT nicholasvalettas octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT jameslvelianou octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT michaelbtsang octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT nataliapinillaecheverri octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT matthewgsibbald octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT matthewgsibbald octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy AT tejnsheth octbaseddiagnosismanagementandpredictorsofrecurrentstentfailureacohortstudy |