Authors:	Boeder, Niklas F. Weissner, Melissa Blachutzik, Florian Ullrich, Helen Anadol, Remzi Tröbs, Monique Münzel, Thomas Hamm, Christian W. Dijkstra, Jouke Achenbach, Stephan Nef, Holger M. Gori, Tommaso
Title:	Incidental finding of strut malapposition is a predictor of late and very late thrombosis in coronary bioresorbable scaffolds
Online publication date:	8-Jul-2019
Year of first publication:	2019
Language:	english
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 malapposition—regardless of the timing of diagnosis of the malapposition—during 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.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-168
URN:	urn:nbn:de:hebis:77-publ-591366
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Journal of Clinical Medicine 8 5
Pages or article number:	Art. 580
Publisher:	MDPI
Publisher place:	Basel
Issue date:	2019
ISSN:	2077-0383
Publisher URL:	http://dx.doi.org/10.3390/jcm8050580
Publisher DOI:	10.3390/jcm8050580
Appears in collections:	JGU-Publikationen