Qualitative and Quantitative Assessment of Stent Restenosis by Optical Coherence Tomography: Comparison Between Drug-Eluting and Bare-Metal Stents

Background: We hypothesized that the tissue components of in-stent restenosis (ISR) might differ between drug-eluting stents (DES) and bare-metal stents (BMS) and that these differences could be distinguished by qualitative and quantitative optical coherence tomography (OCT) analyses. Methods and Re...

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Bibliographic Details
Published in:Circulation Journal 2013, Vol.77(3), pp.652-660
Main Authors: Nagoshi, Ryoji, Shinke, Toshiro, Otake, Hiromasa, Shite, Junya, Matsumoto, Daisuke, Kawamori, Hiroyuki, Nakagawa, Masayuki, Kozuki, Amane, Hariki, Hirotoshi, Inoue, Takumi, Ohsue, Tsuyoshi, Taniguchi, Yu, Iwasaki, Masamichi, Nishio, Ryo, Hiranuma, Noritoshi, Konishi, Akihide, Kinutani, Hiroto, Miyoshi, Naoki, Takaya, Tomofumi, Yamada, Shinichiro, Yasaka, Yoshinori, Hayashi, Takatoshi, Yokoyama, Mitsuhiro, Kato, Hiroki, Kadotani, Makoto, Ohnishi, Yoshio, Hirata, Ken-ichi
Format: Article
Language:English
Subjects:
Aged
Angioplasty, Balloon, Coronary
Bare-metal stents
Coronary Angiography
Coronary Restenosis - epidemiology
Coronary Restenosis - pathology
Coronary Restenosis - prevention & control
Coronary Stenosis - therapy
Drug-Eluting Stents
Female
Humans
In-stent restenosis
Incidence
Male
Metals
Middle Aged
Neointima - diagnostic imaging
Neointima - pathology
Optical coherence tomography
Paclitaxel - administration & dosage
Retrospective Studies
Sirolimus - administration & dosage
Stents
Tomography, Optical Coherence
Treatment Outcome
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Summary:Background: We hypothesized that the tissue components of in-stent restenosis (ISR) might differ between drug-eluting stents (DES) and bare-metal stents (BMS) and that these differences could be distinguished by qualitative and quantitative optical coherence tomography (OCT) analyses. Methods and Results: One-hundred and twenty-two initial ISR lesions (sirolimus-eluting stents: n=28; paclitaxel-eluting stents: n=51; BMS: n=43) were evaluated with OCT. Based on their OCT appearance, the lesions were classified as homogeneous, layered or heterogeneous. The optical properties of backscatter, attenuation and signal intensity of the neointimal tissue (NIT) were quantified. To evaluate the vascular response after balloon angioplasty (BA), the rate of reduction of the NIT area (NITA) was calculated (NITA before – after BA/NITA before BA at the minimum lumen cross-sectional area). Among the morphologic OCT patterns, the layered type was predominant with DES, whereas lesions were homogeneous with BMS (P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-12-0610