In-stent restenosis assessed with frequency domain optical coherence tomography shows smooth coronary arterial healing process in second-generation drug-eluting stents
| Autor: | Ryoichi Arima, Mitsuru Ohishi, Junichiro Takaoka, Nobuhiko Atsuchi, Kengo Fukunaga, Akihiro Miyamura, Mitsuyasu Terashima, Takashi Kajiya, Hiroshi Yamaguchi, Hideaki Kaneda, Yoshihiko Atsuchi, Toshiko Ninomiya |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Neointima Bare-metal stent medicine.medical_treatment Frequency domain optical coherence tomography Constriction Pathologic 030204 cardiovascular system & hematology Coronary Angiography Coronary Restenosis 03 medical and health sciences 0302 clinical medicine Restenosis Optical coherence tomography medicine Humans 030212 general & internal medicine Aged Retrospective Studies Neointimal hyperplasia medicine.diagnostic_test business.industry Incidence Drug-Eluting Stents General Medicine Middle Aged medicine.disease Coronary Vessels Metals Drug-eluting stent Original Article Female In stent restenosis Nuclear medicine business Tomography Optical Coherence |
| Zdroj: | Singapore Medical Journal. 60:48-51 |
| ISSN: | 0037-5675 |
| Popis: | INTRODUCTION The pathophysiology and mechanism of in-stent restenosis (ISR) after implantation of second-generation drug-eluting stents (DESs) are not fully clear. We compared the morphological characteristics of ISR between first- and second-generation DESs using frequency domain optical coherence tomography (OCT). METHODS Patients who underwent follow-up coronary angiography (CAG) after first-generation (CYPHER™ and TAXUS™) and second-generation (Nobori®, PROMUS Element™, Resolute Integrity and XIENCE) DES implantations were examined. ISR was defined as lesions of over 50% diameter stenosis at follow-up CAG. Frequency domain OCT was performed at the time of revascularisation of ISR. Tissue morphology was assessed at minimum lumen area. OCT images of DESs at both early (≤ 1 year) and late (> 1 year) phase follow-up were compared. RESULTS On qualitative OCT assessment, the ratios of homogeneous, layered, heterogeneous without-attenuation and heterogeneous with-attenuation morphologies were 57.1%, 17.1%, 20.0% and 5.7%, respectively, for second-generation DES ISR (n = 35), and 16.7%, 25.0%, 25.0% and 33.3%, respectively, for first-generation DES ISR (n = 36). At late phase follow-up, homogeneous morphology was significantly more common for second-generation DES ISR compared to first-generation DES ISR (first-generation: 8.0% vs. second-generation: 50.0%; p < 0.01) while heterogeneous with-attenuation morphology was significantly more common for first-generation DES ISR (first-generation: 44.0% vs. second-generation: 5.6%; p < 0.01). CONCLUSION Homogeneous tissue morphology was more frequently found for second-generation than first-generation DES ISR, especially in the late phase. This suggested that neointimal hyperplasia was the main mechanism in second-generation DES ISR, and that the neointima was stabilised, much like in bare metal stent implantation. |
| Databáze: | OpenAIRE |
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