In-stent restenosis assessed with frequency domain optical coherence tomography shows smooth coronary arterial healing process in second-generation drug-eluting stents

التفاصيل البيبلوغرافية
العنوان: In-stent restenosis assessed with frequency domain optical coherence tomography shows smooth coronary arterial healing process in second-generation drug-eluting stents
المؤلفون: Ryoichi Arima, Mitsuru Ohishi, Junichiro Takaoka, Nobuhiko Atsuchi, Kengo Fukunaga, Akihiro Miyamura, Mitsuyasu Terashima, Takashi Kajiya, Hiroshi Yamaguchi, Hideaki Kaneda, Yoshihiko Atsuchi, Toshiko Ninomiya
المصدر: Singapore Medical Journal. 60:48-51
بيانات النشر: Medknow, 2019.
سنة النشر: 2019
مصطلحات موضوعية: 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
الوصف: 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.
تدمد: 0037-5675
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::28d73b5e2204a497a0c46b99aba1f0cb
https://doi.org/10.11622/smedj.2018038
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....28d73b5e2204a497a0c46b99aba1f0cb
قاعدة البيانات: OpenAIRE