Optical Coherence Tomographic Observation of Morphological Features of Neointimal Tissue after Drug-Eluting Stent Implantation
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Purpose: The impacts of different time courses and the degree of neointimal growth on neointimal morphology have not yet been sufficiently investigated. Therefore, we evaluated the morphological features of neointimal tissue after drug-eluting stent (DES) implantation using optical coherence tomography (OCT). Materials and Methods: The morphological features of neointimal tissue in stentedsegments with a maximal percentage of cross-sectional area (CSA) stenosis of neointima were evaluated in 507 DES-treated lesions with >100 μm mean neointimalthickness on follow-up OCT. Neointimal tissue was categorized as homogeneous,heterogeneous, layered, or neoatherosclerotic. Results: In lesions with <50% of neointimal CSA stenosis, homogeneous neointima (68.2%) was predominant,followed by heterogeneous neointima (14.1%) and layered neointima (14.1%). In lesions with ≥50% of neointimal CSA stenosis, layered neointima was most frequently observed (68.3%), followed by neoatherosclerotic neointima (25.2%). In subgroup analysis of lesions with ≥50% of neointimal CSA stenosis, 89.5% of the lesions with a stent age <30 months were layered neointima, while 62.3% of the lesions with a stent age ≥30 months were neoatherosclerotic neointima. Conclusion: This study suggests that the OCT-detected morphology of DES neointimal tissue was different according to the follow-up time course and degree of neointimal hyperplasia.
Abstract
Purpose: The impacts of different time courses and the degree of neointimal growth on neointimal morphology have not yet been sufficiently investigated. Therefore, we evaluated the morphological features of neointimal tissue after drug-eluting stent (DES) implantation using optical coherence tomography (OCT). Materials and Methods: The morphological features of neointimal tissue in stentedsegments with a maximal percentage of cross-sectional area (CSA) stenosis of neointima were evaluated in 507 DES-treated lesions with >100 μm mean neointimalthickness on follow-up OCT. Neointimal tissue was categorized as homogeneous,heterogeneous, layered, or neoatherosclerotic. Results: In lesions with <50% of neointimal CSA stenosis, homogeneous neointima (68.2%) was predominant,followed by heterogeneous neointima (14.1%) and layered neointima (14.1%). In lesions with ≥50% of neointimal CSA stenosis, layered neointima was most frequently observed (68.3%), followed by neoatherosclerotic neointima (25.2%). In subgroup analysis of lesions with ≥50% of neointimal CSA stenosis, 89.5% of the lesions with a stent age <30 months were layered neointima, while 62.3% of the lesions with a stent age ≥30 months were neoatherosclerotic neointima. Conclusion: This study suggests that the OCT-detected morphology of DES neointimal tissue was different according to the follow-up time course and degree of neointimal hyperplasia.
참고문헌 (16)
- Gonzalo N, "Optical coherence tomography patterns of stent restenosis", Am Heart J, 158, pp.284~293 (2009)
- 이승률, "Stent Evaluation with Optical Coherence Tomography", Yonsei Medical Journal, 54(5), pp.1075~1083 (2013), 연세대학교의과대학[DOI]
- Kang SJ, "Optical coherence tomographic analysis of in-stent neoatherosclerosis after drug-eluting stent implantation", Circulation, 123, pp.2954~2963 (2011)
- Habara M, "Morphological differences of tissue characteristics between early, late, and very late restenosis lesions after first generation drug-eluting stent implantation: an optical coherence tomography study", Eur Heart J Cardiovasc Imaging, 14, pp.276~284 (2013)
- Lee SJ, "Evaluation of Neointimal Morphology of Lesions With or Without In-Stent Restenosis: An Optical Coherence Tomography Study", CLINICAL CARDIOLOGY, 34(10), pp.633~639 (2011), JOHN WILEY & SONS INC
- Yonetsu T, "Comparison of incidence and time course of neoatherosclerosis between bare metal stents and drug-eluting stents using optical coherence tomography", Am J Cardiol, 110, pp.933~939 (2012)
- Takano M, "Appearance of lipid-laden intima and neovascularization after implantation of bare-metal stents extended late-phase observation by intracoronary optical coherence tomography", J Am Coll Cardiol, 55, pp.26~32 (2009)
- 김웅, "The Initial Extent of Malapposition in ST-Elevation Myocardial Infarction Treated with Drug-Eluting Stent: The Usefulness of Optical Coherence Tomography", Yonsei Medical Journal, 51(3), pp.332~338 (2010), 연세대학교의과대학
- Prati F, "Expert review document on methodology, terminology, and clinical applications of optical coherence tomography: physical principles, methodology of image acquisition, and clinical application for assessment of coronary arteries and atherosclerosis", Eur Heart J, 31, pp.401~415 (2010)
- Lee SY, "Optical coherence tomography-based evaluation of in-stent neoatherosclerosis in lesions with more than 50% neointimal cross-sectional area stenosis", EuroIntervention, 9(8), pp.945~951 (2013), EuroPCR
- Farb A, "Pathology of acute and chronic coronary stenting in humans", Circulation, 99, pp.44~52 (1999)
- van Beusekom HM, "Drug-eluting stents show delayed healing: paclitaxel more pronounced than sirolimus", Eur Heart J, 28, pp.974~979 (2007)
- Chieffo A, "Histopathology of clinical coronary restenosis in drug-eluting versus bare metal stents", Am J Cardiol, 104, pp.1660~1667 (2009)
- Nakano M, "Ex vivo assessment of vascular response to coronary stents by optical frequency domain imaging", JACC Cardiovasc Imaging, 5, pp.71~82 (2012)
- Nagai H, "Histology of highly echolucent regions in optical coherence tomography images from two patients with sirolimus-eluting stent restenosis", Catheter Cardiovasc Interv, 75, pp.961~963 (2010)
- Yonetsu T, "Predictors for neoatherosclerosis: a retrospective observational study from the optical coherence tomography registry", Circ Cardiovasc Imaging, 5, pp.660~666 (2012)