Stent implantation is the most widely used method to treat patients with coronary heart disease. In spite of sophisticated contemporary technology and procedures the treatment is not without its risks. The most serious complication is a sudden re-blockage – called stent thrombosis – which can lead instantly to a heart attack. The risk of stent thrombosis is related to the degree (or lack) of healing in the weeks and months after stent implantation. Accordingly determination of the degree of healing surrounding the stent is crucial to evaluating this potential risk. Cardiologists in the PRESTIGE project have recently developed a new analytical method based on high-resolution imaging performed by passing a fine wire into the body and over the stented segment of the coronary artery. The imaging wire uses light to generate an ultrasound-like image of the vessel wall – with a resolution equivalent to that of a low-power microscope. This technology is called Optical Coherence Tomography (OCT). As different types of tissue deflect the light beam in different ways, the cardiologist can use gray-scale analysis of the images to assess whether the stent is well healed or not and to predict the risk of adverse events. Using this methodology tissue surrounding a stent can be classified as mature (well-healed) or immature (poorly-healed). Immature tissue reflects an incomplete ingrowth of the stent and could trigger stent thrombosis. So far studies with more than 100 patients using the new analysis technology piloted in Munich revealed that whereas after three to six months following implantation, coronary stents remained unhealed and were mostly covered by immature tissue, after a period of nine months most of the stents were well healed and covered by mature tissue. Determination of the degree of healing surrounding the stent is crucial to evaluating the potential risks for complications after stent implantation and in helping physicians to decide when to prescribe treatment – such as blood thinning medication – to prevent these complications. The analytical method is globally unique and has thus far only been applied in the OCT Imaging Laboratory of the German Heart Centre Munich. In fact many international and national enquiries for analyses are handled centrally in Munich. In the future the investigators hope to develop automated software enabling this new method to be integrated into the OCT procedure to enable cardiologists to perform these analyses at the patients’ bed-side. The PRESTIGE Consortium Since 2010 a consortium consisting of 14 European institutions and companies have come together to study the basis of and clinical risk factors of stent thrombosis. The consortium is unique in its combination in this field of research worldwide. The project lasts for four years (2010 to 2014) and is coordinated by the German Heart Centre Munich. The European Commission funds the project PRESTIGE with 6 million Euros. The acronym PRESTIGE stands for „PREvention of late Stent Thrombosis by an Interdisciplinary Global European effort“. Scientists all over Europe develop new concepts of preventing stent thrombosis within the project.
Andorra, Austria, Belgium, Bulgaria, Switzerland, Czechia, Germany, Denmark, Estonia, Greece, Spain, Finland, France, Croatia, Hungary, Ireland, Italy, Liechtenstein, Lithuania, Luxembourg, Latvia, Monaco, Malta, Netherlands, Norway, Poland, Portugal, Romania, Sweden, Slovenia, Slovakia, United Kingdom