{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T17:46:21Z","timestamp":1767980781521,"version":"3.49.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,4,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The pathophysiology underlying very late drug\u2010eluting stent (\n              <jats:styled-content style=\"fixed-case\">DES<\/jats:styled-content>\n              ) thrombosis is not sufficiently understood. Using optical coherence tomography, we investigated characteristics of very late stent thrombosis (\n              <jats:styled-content style=\"fixed-case\">VLST<\/jats:styled-content>\n              ) according to different onset times.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 98 patients from 10 South Korean hospitals who underwent optical coherence tomography for evaluation of very late\n              <jats:styled-content style=\"fixed-case\">DES<\/jats:styled-content>\n              thrombosis were retrospectively included in analyses.\n              <jats:styled-content style=\"fixed-case\">VLST<\/jats:styled-content>\n              occurred at a median of 55.1\u00a0months after\n              <jats:styled-content style=\"fixed-case\">DES<\/jats:styled-content>\n              implantation. All patients were divided into 2 equal groups of earlier versus delayed presentation of\n              <jats:styled-content style=\"fixed-case\">VLST<\/jats:styled-content>\n              , according to median onset time. In total, 27 patients were treated with next\u2010generation\n              <jats:styled-content style=\"fixed-case\">DES<\/jats:styled-content>\n              and 71 with first\u2010generation\n              <jats:styled-content style=\"fixed-case\">DES<\/jats:styled-content>\n              . Based on optical coherence tomography findings at thrombotic sites, main\n              <jats:styled-content style=\"fixed-case\">VLST<\/jats:styled-content>\n              mechanisms were as follows, in descending order: neoatherosclerosis (34.7%), stent malapposition (33.7%), and uncovered struts without stent malapposition or evagination (24.5%). Compared with patients with earlier\n              <jats:styled-content style=\"fixed-case\">VLST<\/jats:styled-content>\n              , patients with delayed\n              <jats:styled-content style=\"fixed-case\">VLST<\/jats:styled-content>\n              had lower frequency of uncovered struts without stent malapposition or evagination (34.7% versus 14.3%, respectively;\n              <jats:italic>P<\/jats:italic>\n              =0.019). Conversely, the frequency of neoatherosclerosis was higher in patients with delayed versus earlier\n              <jats:styled-content style=\"fixed-case\">VLST<\/jats:styled-content>\n              (44.9% versus 24.5%, respectively;\n              <jats:italic>P<\/jats:italic>\n              =0.034). The frequency of stent malapposition was not different between patients with earlier and delayed\n              <jats:styled-content style=\"fixed-case\">VLST<\/jats:styled-content>\n              (34.7% versus 32.7%, respectively;\n              <jats:italic>P<\/jats:italic>\n              =0.831). The frequency of stent malapposition, evagination, and uncovered struts was still half of delayed\n              <jats:styled-content style=\"fixed-case\">VLST<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The pathological mechanisms of very late\n              <jats:styled-content style=\"fixed-case\">DES<\/jats:styled-content>\n              thrombosis changed over time. Delayed neointimal healing remained a substantial substrate for\n              <jats:styled-content style=\"fixed-case\">VLST<\/jats:styled-content>\n              , even long after\n              <jats:styled-content style=\"fixed-case\">DES<\/jats:styled-content>\n              implantation.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.116.005386","type":"journal-article","created":{"date-parts":[[2017,4,15]],"date-time":"2017-04-15T00:20:10Z","timestamp":1492215610000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Characteristics of Earlier Versus Delayed Presentation of Very Late Drug\u2010Eluting Stent Thrombosis: An Optical Coherence Tomographic Study"],"prefix":"10.1161","volume":"6","author":[{"given":"Seung\u2010Yul","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung\u2010Min","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Institute, Asan Medical Center, University of Ulsan, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary S.","family":"Mintz","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung\u2010Ho","family":"Hur","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keimyung University College of Medicine, Daegu, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"So\u2010Yeon","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ajou University Hospital, Suwon, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang\u2010Wook","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Chung\u2010Ang University Medical Center, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Man","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Kyung Hee University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soon Jun","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Korea University Anam Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin Won","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Korea University Guro Hospital, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Joon","family":"Hong","sequence":"additional","affiliation":[{"name":"Departments of Cardiology, Chonnam National University Medical School, Gwangju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang\u2010Gon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ulsan University College of Medicine, Ulsan, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong\u2010Ho","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea"},{"name":"Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung\u2010Sun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea"},{"name":"Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byeong\u2010Keuk","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea"},{"name":"Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young\u2010Guk","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea"},{"name":"Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donghoon","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, 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