Mechanisms of postintervention and nine-month luminal enlargement after treatment of drug-eluting in-stent restenosis with a drug-eluting balloon

Seung Yul Lee, Myeong Ki Hong, Dong Ho Shin, Jung Sun Kim, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Yangsoo Jang

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Using optical coherence tomography (OCT), the mechanisms of postintervention and 9-month luminal enlargement in drug-eluting stent in-stent restenosis (ISR) lesions treated with a drug-eluting balloon (DEB) were evaluated. A total of 42 patients with DEB-treated drug-eluting stent ISR lesions underwent serial OCT examination before intervention, after intervention, and at 9-month follow-up. Preintervention OCT-derived neointima was classified as either a homogeneous or nonhomogeneous pattern. Ten ISR lesions with homogeneous neointima were identified and compared with 32 ISR lesions with nonhomogeneous neointima. When comparing pre- and postintervention evaluations, changes in luminal cross-sectional area (CSA) were 3.4 mm 2 in ISR lesions with homogeneous neointima and 3.7 mm2 in those with nonhomogeneous neointima, respectively (p = 0.529); changes in stent CSA were 2.5 mm2 and 1.4 mm2, respectively, p = 0.004; and changes in neointimal CSA were -0.9 mm2 and -2.3 mm2, respectively, p = 0.001. At 9-month follow-up, changes in luminal CSA were -2.0 mm2 and -0.9 mm2 in ISR lesions with homogeneous and nonhomogeneous neointima, respectively (p = 0.021); in stent CSA changed by -0.2 mm2 in both groups (p = 0.851) and changes in neointimal CSA was 1.8 mm2 and 0.7 mm2, respectively (p = 0.003). At the 9-month follow-up, >50% neointimal CSA stenosis was observed in 60% and 19% of the ISR lesions with homogeneous and nonhomogeneous neointima, respectively (p = 0.020). In conclusion, the mechanism of postintervention luminal enlargement by DEB varied with the preintervention OCT-based neointimal characteristics. ISR lesions with homogeneous neointima determined by OCT were associated with greater subsequent regrowth of neointima after DEB treatment.

Original languageEnglish
Pages (from-to)1468-1473
Number of pages6
JournalAmerican Journal of Cardiology
Volume113
Issue number9
DOIs
Publication statusPublished - 2014 May 1

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Drug-Eluting Stents
Neointima
Stents
Optical Coherence Tomography
Pharmaceutical Preparations
Therapeutics
Pathologic Constriction

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{2570b937ffd94ddf8a0088dfbcf44eb3,
title = "Mechanisms of postintervention and nine-month luminal enlargement after treatment of drug-eluting in-stent restenosis with a drug-eluting balloon",
abstract = "Using optical coherence tomography (OCT), the mechanisms of postintervention and 9-month luminal enlargement in drug-eluting stent in-stent restenosis (ISR) lesions treated with a drug-eluting balloon (DEB) were evaluated. A total of 42 patients with DEB-treated drug-eluting stent ISR lesions underwent serial OCT examination before intervention, after intervention, and at 9-month follow-up. Preintervention OCT-derived neointima was classified as either a homogeneous or nonhomogeneous pattern. Ten ISR lesions with homogeneous neointima were identified and compared with 32 ISR lesions with nonhomogeneous neointima. When comparing pre- and postintervention evaluations, changes in luminal cross-sectional area (CSA) were 3.4 mm 2 in ISR lesions with homogeneous neointima and 3.7 mm2 in those with nonhomogeneous neointima, respectively (p = 0.529); changes in stent CSA were 2.5 mm2 and 1.4 mm2, respectively, p = 0.004; and changes in neointimal CSA were -0.9 mm2 and -2.3 mm2, respectively, p = 0.001. At 9-month follow-up, changes in luminal CSA were -2.0 mm2 and -0.9 mm2 in ISR lesions with homogeneous and nonhomogeneous neointima, respectively (p = 0.021); in stent CSA changed by -0.2 mm2 in both groups (p = 0.851) and changes in neointimal CSA was 1.8 mm2 and 0.7 mm2, respectively (p = 0.003). At the 9-month follow-up, >50{\%} neointimal CSA stenosis was observed in 60{\%} and 19{\%} of the ISR lesions with homogeneous and nonhomogeneous neointima, respectively (p = 0.020). In conclusion, the mechanism of postintervention luminal enlargement by DEB varied with the preintervention OCT-based neointimal characteristics. ISR lesions with homogeneous neointima determined by OCT were associated with greater subsequent regrowth of neointima after DEB treatment.",
author = "Lee, {Seung Yul} and Hong, {Myeong Ki} and Shin, {Dong Ho} and Kim, {Jung Sun} and Kim, {Byeong Keuk} and Ko, {Young Guk} and Donghoon Choi and Yangsoo Jang",
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Mechanisms of postintervention and nine-month luminal enlargement after treatment of drug-eluting in-stent restenosis with a drug-eluting balloon. / Lee, Seung Yul; Hong, Myeong Ki; Shin, Dong Ho; Kim, Jung Sun; Kim, Byeong Keuk; Ko, Young Guk; Choi, Donghoon; Jang, Yangsoo.

In: American Journal of Cardiology, Vol. 113, No. 9, 01.05.2014, p. 1468-1473.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Mechanisms of postintervention and nine-month luminal enlargement after treatment of drug-eluting in-stent restenosis with a drug-eluting balloon

AU - Lee, Seung Yul

AU - Hong, Myeong Ki

AU - Shin, Dong Ho

AU - Kim, Jung Sun

AU - Kim, Byeong Keuk

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Jang, Yangsoo

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N2 - Using optical coherence tomography (OCT), the mechanisms of postintervention and 9-month luminal enlargement in drug-eluting stent in-stent restenosis (ISR) lesions treated with a drug-eluting balloon (DEB) were evaluated. A total of 42 patients with DEB-treated drug-eluting stent ISR lesions underwent serial OCT examination before intervention, after intervention, and at 9-month follow-up. Preintervention OCT-derived neointima was classified as either a homogeneous or nonhomogeneous pattern. Ten ISR lesions with homogeneous neointima were identified and compared with 32 ISR lesions with nonhomogeneous neointima. When comparing pre- and postintervention evaluations, changes in luminal cross-sectional area (CSA) were 3.4 mm 2 in ISR lesions with homogeneous neointima and 3.7 mm2 in those with nonhomogeneous neointima, respectively (p = 0.529); changes in stent CSA were 2.5 mm2 and 1.4 mm2, respectively, p = 0.004; and changes in neointimal CSA were -0.9 mm2 and -2.3 mm2, respectively, p = 0.001. At 9-month follow-up, changes in luminal CSA were -2.0 mm2 and -0.9 mm2 in ISR lesions with homogeneous and nonhomogeneous neointima, respectively (p = 0.021); in stent CSA changed by -0.2 mm2 in both groups (p = 0.851) and changes in neointimal CSA was 1.8 mm2 and 0.7 mm2, respectively (p = 0.003). At the 9-month follow-up, >50% neointimal CSA stenosis was observed in 60% and 19% of the ISR lesions with homogeneous and nonhomogeneous neointima, respectively (p = 0.020). In conclusion, the mechanism of postintervention luminal enlargement by DEB varied with the preintervention OCT-based neointimal characteristics. ISR lesions with homogeneous neointima determined by OCT were associated with greater subsequent regrowth of neointima after DEB treatment.

AB - Using optical coherence tomography (OCT), the mechanisms of postintervention and 9-month luminal enlargement in drug-eluting stent in-stent restenosis (ISR) lesions treated with a drug-eluting balloon (DEB) were evaluated. A total of 42 patients with DEB-treated drug-eluting stent ISR lesions underwent serial OCT examination before intervention, after intervention, and at 9-month follow-up. Preintervention OCT-derived neointima was classified as either a homogeneous or nonhomogeneous pattern. Ten ISR lesions with homogeneous neointima were identified and compared with 32 ISR lesions with nonhomogeneous neointima. When comparing pre- and postintervention evaluations, changes in luminal cross-sectional area (CSA) were 3.4 mm 2 in ISR lesions with homogeneous neointima and 3.7 mm2 in those with nonhomogeneous neointima, respectively (p = 0.529); changes in stent CSA were 2.5 mm2 and 1.4 mm2, respectively, p = 0.004; and changes in neointimal CSA were -0.9 mm2 and -2.3 mm2, respectively, p = 0.001. At 9-month follow-up, changes in luminal CSA were -2.0 mm2 and -0.9 mm2 in ISR lesions with homogeneous and nonhomogeneous neointima, respectively (p = 0.021); in stent CSA changed by -0.2 mm2 in both groups (p = 0.851) and changes in neointimal CSA was 1.8 mm2 and 0.7 mm2, respectively (p = 0.003). At the 9-month follow-up, >50% neointimal CSA stenosis was observed in 60% and 19% of the ISR lesions with homogeneous and nonhomogeneous neointima, respectively (p = 0.020). In conclusion, the mechanism of postintervention luminal enlargement by DEB varied with the preintervention OCT-based neointimal characteristics. ISR lesions with homogeneous neointima determined by OCT were associated with greater subsequent regrowth of neointima after DEB treatment.

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