Abstract
Background: Characterization of neointimal tissue is essential to understand the pathophysiology of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation. Using optical coherence tomography (OCT), we compared the morphologic characteristics of in-stent neointimal tissue from 33 ISR lesions with those of 192 non-ISR lesions after DES implantation. Hypothesis: We hypothesized that the morphologic characteristics of in-stent neointimal tissue from ISR lesions were different from those of non-ISR lesions after DES implantation. Methods: The DES were coated with sirolimus (n=52), paclitaxel (n=57), zotarolimus (n=84), or everolimus (n=32). In-stent restenosis was defined as ≥50% diameter stenosis at the follow-up angiogram. Lesions with ≥10% neointimal burden ([neointima area × 100]/[stent area]), as determined by OCT, were included in this study. A follow-up OCT (mean follow-up duration, 12.0 ± 10.5 mo) was performed in 209 patients with 225 lesions (ISR lesions, n=33; non-ISR lesions, n=192). Qualitative OCT was used to assess tissue structure, backscatter, visible microvessels, and presence of intraluminal material. Results: The following characteristics were more common in ISR lesions than in non-ISR lesions: heterogeneous or layered tissues (78.8% vs 22.9%, P<0.001), low backscatter (60.6% vs 20.8%, P<0.001), and microvessels (48.5% vs 5.7%, P<0.001). The independent predictors for heterogeneous or layered neointimal tissues were increased neointima burden (odds ratio [OR]: 1.218, 95% confidence interval [CI]: 1.096-1.354, P<0.001), lumen area (OR: 4.672, 95% CI: 1.371-15.914, P = 0.014), and hypertension (OR: 0.415, 95% CI: 0.186-0.926, P = 0.032). Conclusions: This follow-up OCT study demonstrated that morphologic characteristics of neointimal tissues of ISR lesions differ from those of non-ISR lesions.
| Original language | English |
|---|---|
| Pages (from-to) | 633-639 |
| Number of pages | 7 |
| Journal | Clinical Cardiology |
| Volume | 34 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 2011 Oct 1 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Evaluation of neointimal morphology of lesions with or without in-stent restenosis : An optical coherence tomography study. / Lee, Sung Joo; Kim, Byeong Keuk; Kim, Jung Sun; Ko, Young Guk; Choi, Donghoon; Jang, Yangsoo; Hong, Myeongki.
In: Clinical Cardiology, Vol. 34, No. 10, 01.10.2011, p. 633-639.Research output: Contribution to journal › Article
TY - JOUR
T1 - Evaluation of neointimal morphology of lesions with or without in-stent restenosis
T2 - An optical coherence tomography study
AU - Lee, Sung Joo
AU - Kim, Byeong Keuk
AU - Kim, Jung Sun
AU - Ko, Young Guk
AU - Choi, Donghoon
AU - Jang, Yangsoo
AU - Hong, Myeongki
PY - 2011/10/1
Y1 - 2011/10/1
N2 - Background: Characterization of neointimal tissue is essential to understand the pathophysiology of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation. Using optical coherence tomography (OCT), we compared the morphologic characteristics of in-stent neointimal tissue from 33 ISR lesions with those of 192 non-ISR lesions after DES implantation. Hypothesis: We hypothesized that the morphologic characteristics of in-stent neointimal tissue from ISR lesions were different from those of non-ISR lesions after DES implantation. Methods: The DES were coated with sirolimus (n=52), paclitaxel (n=57), zotarolimus (n=84), or everolimus (n=32). In-stent restenosis was defined as ≥50% diameter stenosis at the follow-up angiogram. Lesions with ≥10% neointimal burden ([neointima area × 100]/[stent area]), as determined by OCT, were included in this study. A follow-up OCT (mean follow-up duration, 12.0 ± 10.5 mo) was performed in 209 patients with 225 lesions (ISR lesions, n=33; non-ISR lesions, n=192). Qualitative OCT was used to assess tissue structure, backscatter, visible microvessels, and presence of intraluminal material. Results: The following characteristics were more common in ISR lesions than in non-ISR lesions: heterogeneous or layered tissues (78.8% vs 22.9%, P<0.001), low backscatter (60.6% vs 20.8%, P<0.001), and microvessels (48.5% vs 5.7%, P<0.001). The independent predictors for heterogeneous or layered neointimal tissues were increased neointima burden (odds ratio [OR]: 1.218, 95% confidence interval [CI]: 1.096-1.354, P<0.001), lumen area (OR: 4.672, 95% CI: 1.371-15.914, P = 0.014), and hypertension (OR: 0.415, 95% CI: 0.186-0.926, P = 0.032). Conclusions: This follow-up OCT study demonstrated that morphologic characteristics of neointimal tissues of ISR lesions differ from those of non-ISR lesions.
AB - Background: Characterization of neointimal tissue is essential to understand the pathophysiology of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation. Using optical coherence tomography (OCT), we compared the morphologic characteristics of in-stent neointimal tissue from 33 ISR lesions with those of 192 non-ISR lesions after DES implantation. Hypothesis: We hypothesized that the morphologic characteristics of in-stent neointimal tissue from ISR lesions were different from those of non-ISR lesions after DES implantation. Methods: The DES were coated with sirolimus (n=52), paclitaxel (n=57), zotarolimus (n=84), or everolimus (n=32). In-stent restenosis was defined as ≥50% diameter stenosis at the follow-up angiogram. Lesions with ≥10% neointimal burden ([neointima area × 100]/[stent area]), as determined by OCT, were included in this study. A follow-up OCT (mean follow-up duration, 12.0 ± 10.5 mo) was performed in 209 patients with 225 lesions (ISR lesions, n=33; non-ISR lesions, n=192). Qualitative OCT was used to assess tissue structure, backscatter, visible microvessels, and presence of intraluminal material. Results: The following characteristics were more common in ISR lesions than in non-ISR lesions: heterogeneous or layered tissues (78.8% vs 22.9%, P<0.001), low backscatter (60.6% vs 20.8%, P<0.001), and microvessels (48.5% vs 5.7%, P<0.001). The independent predictors for heterogeneous or layered neointimal tissues were increased neointima burden (odds ratio [OR]: 1.218, 95% confidence interval [CI]: 1.096-1.354, P<0.001), lumen area (OR: 4.672, 95% CI: 1.371-15.914, P = 0.014), and hypertension (OR: 0.415, 95% CI: 0.186-0.926, P = 0.032). Conclusions: This follow-up OCT study demonstrated that morphologic characteristics of neointimal tissues of ISR lesions differ from those of non-ISR lesions.
UR - http://www.scopus.com/inward/record.url?scp=80054122183&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80054122183&partnerID=8YFLogxK
U2 - 10.1002/clc.20960
DO - 10.1002/clc.20960
M3 - Article
C2 - 21928365
AN - SCOPUS:80054122183
VL - 34
SP - 633
EP - 639
JO - Clinical Cardiology
JF - Clinical Cardiology
SN - 0160-9289
IS - 10
ER -