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THE MORPHOLOGICAL FINDINGS OF IN-STENT RESTENOTIC TISSUE AFTER FIRST GENERATION DRUG-ELUTING STENT IMPLANTATION: OPTICAL COHERENCE TOMOGRAPHY STUDY
E124 JACC March 27, 2012 Volume 59, Issue 13
ACC-i2 with TCT THE MORPHOLOGICAL FINDINGS OF IN-STENT RESTENOTIC TISSUE AFTER FIRST GENERATION DRUGELUTING STENT IMPLANTATION: OPTICAL COHERENCE TOMOGRAPHY STUDY i2 Poster Contributions McCormick Place South, Hall A Saturday, March 24, 2012, 9:30 a.m.-Noon
Session Title: Intravascular Diagnostics Abstract Category: 3. Intravascular Diagnostics Presentation Number: 2527-484 Authors: Maoto Habara, Mitsuyasu Terashima, Kenya Nasu, Euihong Ko, Yoshihisa Kinoshita, Etsuo Tsuchikane, Takahiko Suzuki, Toyohashi Heart Center, Toyohashi, AL, Japan Background: The mechanisms of drug-eluting stent (DES) restenosis might be different from bare-metal stent (BMS) and they are not fully understood. To gain insight into the mechanisms of DES restenosis, we evaluated the characteristics of the in-stent restenosis (ISR) lesions of 1st generation DES using optical coherence tomography (OCT). Methods: We compared the morphological characteristics of early ISR (< 1.5 year: E-ISR, n=46), late ISR (1.5 - 4 years: L-ISR, n=24) and very late ISR (> 4years: VL-ISR, n=16). OCT qualitative restenotic tissue analysis included assessment of tissue structure (homogeneous or heterogeneous [classified type1 to type4]), presence of peri-strut low intensity area (PLIA), microvessels, disruption with cavity, intraluminal materials, and was performed at every 1mm slice of the entire stent. Results: The proportion of heterogeneous image was similar between the three groups. However, thin-cap fibroatheroma like pattern image (type1), intra-intima microvessels, disrupted intima with cavity and intraluminal materials were increased from early to very late phase. On the other hand, patchy pattern image (type3), speckled pattern image (type4) and PLIA were decreased form early to very late phase. Conclusions: The OCT morphological characteristics of DES restenotic tissue were different by the time course. OCT image in DES E-ISR might be associated with delayed arterial healing, and neo-atherosclerosis might contribute to DES L-ISR and VL-ISR.
ACC-i2 with TCT THE MORPHOLOGICAL FINDINGS OF IN-STENT RESTENOTIC TISSUE AFTER FIRST GENERATION DRUGELUTING STENT IMPLANTATION: OPTICAL COHERENCE TOMOGRAPHY STUDY i2 Poster Contributions McCormick Place South, Hall A Saturday, March 24, 2012, 9:30 a.m.-Noon
Session Title: Intravascular Diagnostics Abstract Category: 3. Intravascular Diagnostics Presentation Number: 2527-484 Authors: Maoto Habara, Mitsuyasu Terashima, Kenya Nasu, Euihong Ko, Yoshihisa Kinoshita, Etsuo Tsuchikane, Takahiko Suzuki, Toyohashi Heart Center, Toyohashi, AL, Japan Background: The mechanisms of drug-eluting stent (DES) restenosis might be different from bare-metal stent (BMS) and they are not fully understood. To gain insight into the mechanisms of DES restenosis, we evaluated the characteristics of the in-stent restenosis (ISR) lesions of 1st generation DES using optical coherence tomography (OCT). Methods: We compared the morphological characteristics of early ISR (< 1.5 year: E-ISR, n=46), late ISR (1.5 - 4 years: L-ISR, n=24) and very late ISR (> 4years: VL-ISR, n=16). OCT qualitative restenotic tissue analysis included assessment of tissue structure (homogeneous or heterogeneous [classified type1 to type4]), presence of peri-strut low intensity area (PLIA), microvessels, disruption with cavity, intraluminal materials, and was performed at every 1mm slice of the entire stent. Results: The proportion of heterogeneous image was similar between the three groups. However, thin-cap fibroatheroma like pattern image (type1), intra-intima microvessels, disrupted intima with cavity and intraluminal materials were increased from early to very late phase. On the other hand, patchy pattern image (type3), speckled pattern image (type4) and PLIA were decreased form early to very late phase. Conclusions: The OCT morphological characteristics of DES restenotic tissue were different by the time course. OCT image in DES E-ISR might be associated with delayed arterial healing, and neo-atherosclerosis might contribute to DES L-ISR and VL-ISR.