Aims: To investigate the incidence of incomplete stent apposition and to explore the impact of the presence of thrombus and protruding plaque after stent implantation on neointima formation at follow-up in ST-segment elevation myocardial infarction (STEMI) patients with serial optical frequency domain imaging (OFDI) investigations. Methods and results: In a multi-centre study, 141 patients with ST elevation myocardial infarction, <12 h from on set were randomized to either PPCI with thrombectomy (TB) using an Eliminate catheter (TB: n = 71) or without TB(non-TB: n = 70).OFDI after drugeluting stentingwas performed using TERUMOOFDI system. Per protocol, at follow-up 49 patients segmentswere reimaged. At post-procedure and follow-up, there were no differences in stent and lumen areas between the two groups. At follow-up, per strut-level analysis, percentage of incompletely apposed struts was 0.42±0.94 vs. 0.38±0.77% (P = 0.76), and percentage of covered struts was 92.7±7.2 vs. 94.4±9.2% (P = 0.47) in the TB and non-TB groups, respectively. There was a positive correlation between intra-stent structure (ISS) volume at post-procedure and the neointima volume at 6-month follow-up (Pearson's r = 0.409, P = 0.04). Up to 12 months, there have been two and four patients having target vessel failure in the TB and in the non-TB groups, respectively. Conclusions: In patients with STEMI, therewere no significant differences in OFDI parameters between TB and non-TB groups at both post-procedure and 6-month follow-up. However, ISS volume at post-procedure was positively associated with neointimal volume at 6-month follow-up.

Acute myocardial infarction, Coronary artery disease, Coronary thrombosis, Optical coherence tomography, Prolapse,
European Heart Journal Cardiovascular Imaging
Department of Cardio-Thoracic Surgery

Garcia-Garcia, H.M, Muramatsu, T, Nakatani, T, Lee, I.-S, Holm, N.R, Thuesen, L, … Serruys, P.W.J.C. (2014). Serial optical frequency domain imaging in STEMI patients: The follow-up report of TROFI study. European Heart Journal Cardiovascular Imaging, 15(9), 987–995. doi:10.1093/ehjci/jeu042