In-stent neointimal characteristics and late neointimal response after drug-eluting stent implantation: A preliminary observation.

Abstract

BACKGROUND:

Progressive neointimal proliferation may lead to late restenosis and/or neoatherosclerosis after drug-eluting stent (DES) implantation. Late neointimal response may be different among different tissue characteristics. The aim of this study was to assess impact of in-stent neointimal characteristics on late neointimal response following DES implantation.

METHODS:

Serial (median 270 days and median 551 days after stent implantation) optical coherence tomography (OCT) examinations were performed in 42 stented lesions from 26 patients. In-stent neointimal tissue was categorized as either homogeneous or heterogeneous neointima based on the OCT appearance at 1st follow-up. Serial changes in neointimal area (NIA) were compared between lesions with homogeneous neointima and those with heterogeneous neointima.

RESULTS:

At first follow-up, homogeneous neointima was observed in 22 (52%) and heterogeneous neointima in 20 (48%) lesions, respectively. During follow-up, NIA in lesions with homogeneous neointima decreased significantly (1.8±0.93 mm(2) to 1.5±0.88 mm(2), p<0.001). On the other hand, NIA in lesions with heterogeneous neointima did not change significantly (2.7±1.8 mm(2) to 2.8±1.6 mm(2), p=0.658). Homogeneous neointima was the only predictor of late neointimal regression (late neointimal regression defined as NIA at first follow-up - NIA at second follow-up <0) by multivariable analysis (odds ratio=7.591, 95% confidence interval: 1.616-35.67, p=0.010).

CONCLUSIONS:

OCT characteristics of neointima after DES implantation may be related to late neointimal progression or regression.

• Authors: Kenzo Fukuhara, Hiroyuki Okura, Teruyoshi Kume, Ryotaro Yamada, Yoji Neishi, Shiro Uemura
• Journal: Journal of cardiology (J Cardiol) Vol. 67 Issue 5 Pg. 437-41 (May 2016) ISSN: 1876-4738 [Electronic] Netherlands
• PMID: 26276105 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Topics

• Aged
• Coronary Stenosis (therapy)
• Drug-Eluting Stents
• Female
• Follow-Up Studies
• Humans
• Male
• Neointima (diagnostic imaging)
• Retrospective Studies
• Tomography, Optical Coherence