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With great interest I read the article by Otake et al. (1) assessing the determinants of subclinical thrombus after sirolimus-eluting stent implantation using optical coherence tomography. The authors demonstrated that average stent eccentricity index (minimum/maximum stent diameter) and stent length were associated with the presence of thrombus. The authors speculate that “asymmetric stent expansion affects thrombus formation in part due to uneven stent coverage and healing.” To examine local determinants on the presence of thrombus, an additional within-patient analysis may be helpful. Was stent expansion more asymmetric at (or near) the segment with thrombus than that at the segment without thrombus in a patient?
- American College of Cardiology Foundation