Early healing of the struts is a major challenge to reduce the risk of late stent thrombosis (LST), and for decreasing the duration of dual antiplatelet therapy (1 or 3 months), in patients high risk of bleeding. The bioresorbable polymer everolimus eluting stent (EES) SYNERGY, new generation of stent, has biocompatibility and mechanical properties, allowing complete strut coverage throughout the entire length of the stent at 3 months, in humans, resulting in a low rate of LST. Optical Coherence tomography analysis (OCT), which provide the best spatial resolution, is the method of choice to evaluate early healing of the strut.

To estimate the early healing of the strut at 1 month after implantation of the EES, using OCT analysis, in patients admitted for acute coronary syndrome without ST segment elevation.

This was a prospective and mono-centric study performed at the university hospital the North of Marseille. The patients eligible had to benefit from complementary angioplasty at 1 month after implantation of the EES for the culprit lesion of the acute coronary syndrome. An OCT of EES implanted was performed.

OCT analysis and proofreading of coronary angiography were achieved by 2 physicians practicing these tests on daily basis.

The primary study endpoint was the percentage of uncovered struts in OCT imaging, at 1 month (Fig. 1).

Twenty-four patients were included between December 2016 and February 2018. The percentage of uncovered struts was 21,48±10% of 3849 struts analyzed.

The neointimal thickness facing covered struts was 0,0508±0,016mm.

At follow-up, no ischemic event was reported, however, one death by hemorrhagic stroke was identified.

The percentage of uncovered struts of the SYNERGY stent was 21,48% at 1 month post angioplasty in the context of ACS. This result provides a logical rationale for decreasing the duration of dual antiplatelet therapy at 1 month in patients at high risk of bleeding.