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    1. Long‐Term Clinical Outcomes of Late Stent Malapposition Detected by Optical Coherence Tomography After Drug‐Eluting Stent Implantation

      Long‐Term Clinical Outcomes of Late Stent Malapposition Detected by Optical Coherence Tomography After Drug‐Eluting Stent Implantation

      Background The relationship between late stent malapposition (LSM) and adverse cardiovascular events is controversial. Studies are needed to evaluate long‐term (>5 years) clinical outcomes of LSM detected by optical coherence tomography (OCT) after drug‐eluting stent implantation. Methods and Results We investigated long‐term clinical outcomes of OCT‐detected LSM in 351 patients who received drug‐eluting stents and were examined by both poststent and follow‐up OCT (175±60 days after drug‐eluting stent implantation) from January 2009 to December 2011. LSM was observed in 99 patients (28%). We evaluated the cumulative rate of composite events (cardiovascular death ...

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    2. The “Oculo‐Appositional Reflex”: Should Optical Coherence Tomography–Detected Stent Malapposition Be Corrected?

      The “Oculo‐Appositional Reflex”: Should Optical Coherence Tomography–Detected Stent Malapposition Be Corrected?

      Stent malposition, recognized as an entity with the advent of intravascular imaging, refers to the lack of full contact between stent struts and the vessel wall after percutaneous coronary intervention ( Figure ). Malapposition may be present immediately after placement of stents (acute stent malapposition), or it may develop later (late stent malapposition), which can, in turn, be categorized as late persistent malapposition (ongoing since the time of implantation) or late acquired malapposition (developing de novo during follow‐up). 1

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    3. Early Follow-Up Optical Coherence Tomographic Findings of Significant Drug-Eluting Stent Malapposition

      Early Follow-Up Optical Coherence Tomographic Findings of Significant Drug-Eluting Stent Malapposition

      Background: Using optical coherence tomography, we evaluated early follow-up findings of significant stent malapposition (SSM) in patients treated with second-generation drug-eluting stent. Methods and Results: From the DETECT-OCT randomized trial (Determination of the Duration of the Dual Antiplatelet Therapy by the Degree of the Coverage of the Struts on Optical Coherence Tomography From the Randomized Comparison Between Everolimus- Versus Biolimus-Eluting Stent), a total of 386 patients (390 lesions) who underwent both postintervention and 3-month follow-up optical coherence tomography examinations were included for the present analysis. SSM was defined as a stent that had a strut with a maximal wall-to-strut distance ...

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    4. Management of Left Main Coronary Artery Disease

      Management of Left Main Coronary Artery Disease

      Left main coronary artery disease (LMCAD) portends higher prognostic risk as a result of the large myocardial territory at risk, ranging from 75% to 100%, depending on the dominance of the left coronary circulation. Diagnosis and management of significant LMCAD continues to be a source of clinical apprehension and uncertainty. LMCAD is not uncommonly found in stable patients undergoing coronary angiography and is often associated with concomitant coronary artery disease (CAD). Current clinical practice guidelines from both the American College of Cardiology/ American Heart Association and the European Society of Cardiology recommend revascularization for all patients with ≥50% stenosis of ...

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