Geraud Souteyrand, Nicolas Amabile, Lionel Mangin, Xavier Chabin, Nicolas Meneveau, Guillaume Cayla Gerald Vanzetto, Pierre Barnay, Charlotte Trouillet, Gilles Rioufoll, Gregoire Rangé, Emmanuel Teiger,  Regis Delaunay, Olivier Dubreuil,  Aurélien Mulliez, Sebastien Levesque, Loic Belle, Christophe
Caussin, and Pascal Motreff on behalf of the PESTO investigators

POTENTIAL CONFLICT OF INTEREST : Geraud Souteyrand received Institutional Grant/ Research Support from Abbott Vascular, St Jude Medical, Terumo

Click Images to enlarge :: Cliquez sur l’image à agrandir

BASELINE CHARACTERISTICS
N=120 out of 123 subjects were included in the final analysis (3 patients (2.4%) were excluded for inadequate image quality)

TYPES OF ST & UNDERLYING STENT

ANALYSIS 120 PATIENTS

Thrombosis causes morphological abnormality in 97% of cases

Results : OCT analysis 120 patients

Mechanisms of stent thrombosis according to clinical presentation

Type & mechanisms of stent thrombosis according to stent type

Decision therapy

Analysis 120 patients

Cause	Coronarography
Undetermined	42 %
Probable	36 %
Certain	12 %

OCT influenced the management in 55%  of cases.

CONCLUSION

Pesto Limits

No data regarding platelet function testing or genetic testing in our population

A substantial number of patients presenting with ST were not
included in the study  (inadequate clinical presentation or impossibility to restore TIMI 3 flow without PCI before OCT images acquisition) 

OCT limits

Distal lesions, stent not crossed

Stent thrombosis

Coronarography is not sufficient to stent thrombosis diagnosis in a majority of cases 

Mechanisms of stent thrombosis are multifactorial

 OCT helps for the diagnosis and the management  

Malapposition is the main cause of stent thrombosis  

Using OCT in PESTO medical therapy is enough in 1/3 of cases