THE CONSEQUENCES OF THE SETTING OF DRUG-ELUTING STENTS FOR CHRONIC TOTAL OCCLUSION OF CORONARY ARTERIES: STUDY BY OPTICAL COHERENCE TOMOGRAPHY

The objectives of the study were to analyze the frequency of malapposition and stent coverage in patients with chronic total occlusion (CTO) lesions and non-CTO lesions after drug-eluting stent (DES) implantation by optical coherence tomography (OCT). In total 64 patients with 68 lesions targeted for coronary revascularization were enrolled in the study. All of the patients underwent OCT imaging immediate after stenting and 6 months after it. Examination was conducted using OCT device in frequency field (C7- XR OCT Intravascular Imaging System, St. Jude Medical, St. Paul, Minnesota). Patients were divided into 3 groups: first group - patients with CTO, second group - lipid rich plaques without CTO, third group - non-lipid rich plaques without CTO. LRP was de-fined as the plaque with lipid content in 2 quadrants. Non-LRP consisted of fibrous, fibrocalcific plaque, and lipid plaque with less than 2 quadrants lipid content.Malapposition, tissue protrusion, and intrastent thrombus were more frequent in the CTO and LRP groups. At 6-month followup, malapposition and cross sections with uncovered struts were most frequently observed in the CTO group. Although the incidence of stent thrombosis was non-significantly higher in the CTO group than the other two groups, no events were observed in patients with CTO.Thus, patients with CTO lesions showed unfavorable responses to DES in the acute phase as well as at the 6-month follow-up, indicating the link between the lesion morphology and artery healing process.Key words: chronic total occlusion, optical coherence tomography, stents.

хроническая тотальная окклюзия, оптическая когерентная томография, стенты, chronic total occlusion, optical coherence tomography, stents

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