Optical coherence tomography evaluation of in-stent restenotic lesions with visible microvessels

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

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

OBJECTIVE: We sought to evaluate the characteristics of in-stent restenosis (ISR) lesions with microvessels, detected by an optical coherence tomography (OCT). BACKGROUND: No sufficient in vivo data exist regarding microvessel characteristics in ISR lesions. METHODS: Among 78 ISR lesions (drug-eluting stent, n = 72; bare-metal stent, n = 6) in our OCT registry database, visible microvessels were detected in 21 (27%). Microvessels were defined as low backscattering structures <200 m in diameter on OCT. Clinical, angiographic, and OCT findings were compared between lesions with and without microvessels. RESULTS: Lesions with microvessels had a larger reference vessel diameter (2.90 ± 0.47 mm 2 vs 2.58 ± 0.42 mm 2; P=.009) and post-stent minimum lumen diameter (2.76 ± 0.29 mm 2 vs 2.54 ± 0.39 mm 2; P=.033) than those without microvessels. From OCT findings at the segment with minimal lumen cross-sectional area (CSA), neointimal hyperplasia (NIH) CSA (5.4 ± 1.7 mm 2 vs 4.2 ± 2.1 mm 2; P=.024) and percent NIH CSA (NIH CSA x 100/stent CSA) were significantly greater in lesions with microvessels (79 ± 12% vs 67 ± 16%; P=.001). On multivariate analysis, reference vessel diameter (odds ratio [OR], 4.64; 95% confidence interval [CI], 1.05-20.4; P=.043) and percent NIH CSA at the segment with minimal lumen CSA (OR, 1.06; 95% CI, 1.01-1.12; P=.021) were independent predictors of microvessels. From receiver operating characteristic analysis, the cut-off values of reference vessel diameter and percent NIH CSA predicting the presence of microvessels were 3.1 mm 2 and 74%, respectively. CONCLUSIONS: Visible microvessels in ISR lesions might be associated with increased vessel size and extent of NIH.

Original languageEnglish
Pages (from-to)116-120
Number of pages5
JournalJournal of Invasive Cardiology
Volume24
Issue number3
Publication statusPublished - 2012 Mar

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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