Outcomes of everolimus-eluting stent incomplete stent apposition: a serial optical coherence tomography analysis

Aim The aim of the present study was to evaluate the natural course of acute incomplete stent apposition (ISA) after secondgeneration everolimus-eluting stent (EES) when compared with first-generation sirolimus-eluting stent (SES) by using optical coherence tomography (OCT). Methods and results From the OCT substudy of the RESET trial, we identified 77 patients (EES = 38 and SES = 39) who successfully underwent serialOCTexamination at post-stenting and 8-12-month follow-up. The presence of ISAwas assessed in the OCT images, and ISA distance was measured from the centre of the strut blooming to the adjacent lumen border. Incomplete stent apposition was observed in all EES and SES at post-stenting, and it was persistent in 26% of EES and 38% of SES at 8-12-month follow-up. Maximum ISA distance was significantly decreased during the follow-up period in both EES (315 +/- 94 110 +/- 165 mu m, P < 0.001) and SES (308 +/- 119 143 +/- 195 mu m, P < 0.001). Receiver-operating curve analysis identified that the best cut-off value of OCT-estimated ISA distance at post-stenting for predicting late-persistent ISA at 8-12-month follow-up in EES and SES was >355 and >285 mm, respectively. Conclusions The second-generation EES showed better healing of acute ISA in comparison with the first-generation SES. Optical coherence tomography can predict late-persistent ISA afterDES implantation and provide useful information to optimize PCI.