Angioscopic Evaluation of Vascular Response After Fluoropolymer-Based Drug-Eluting Stent Implantation for Femoropopliteal Artery Lesions.

Abstract

BACKGROUND:

Although favorable clinical outcomes have been demonstrated for fluoropolymer-based paclitaxel-eluting stents (FP-DES) in the treatment of femoropopliteal lesions, the vascular response after implantation has not been systematically studied through intravascular imaging.Methods and Results: We angioscopically compared FP-DES: 24 in the early phase (mean [±SD] 3±1 months), 26 in the middle phase (12±3 months), and 20 in the late phase (≥18 months) after implantation. The dominant neointimal coverage grade, heterogeneity of neointimal coverage grade, and thrombus adhesion in the stent segment were evaluated. Neointimal coverage was graded as follows: Grade 0, stent struts exposed; Grade 1, struts bulging into the lumen, although covered; Grade 2, struts embedded in the neointima, but visible; Grade 3, struts fully embedded and invisible. Dominant neointimal coverage and heterogeneity grades were significantly higher in the middle and late phases than in the early phase (all P<0.05), but did not differ significantly between the middle and late phases. The incidence of thrombus adhesion was recorded for all stents in each of the 3 different phases.

CONCLUSIONS:

The middle and late phases after FP-DES implantation were associated with significantly higher dominant neointimal coverage and heterogeneity grades than the early phase. However, thrombus adhesion was observed in all phases after FP-DES implantation. Arterial healing may not be completed even in the late phase after FP-DES implantation.

• Authors: Takuya Tsujimura, Osamu Iida, Takayuki Ishihara, Mitsutoshi Asai, Masaharu Masuda, Shin Okamoto, Kiyonori Nanto, Yasuhiro Matsuda, Yosuke Hata, Hiroyuki Uematsu, Taku Toyoshima, Naoko Higashino, Sho Nakao, Toshiaki Mano
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 87 Issue 3 Pg. 432-429 (02 24 2023) ISSN: 1347-4820 [Electronic] Japan
• PMID: 36624062 (Publication Type: Journal Article)

Chemical References

• Fluorocarbon Polymers

Topics

• Humans
• Drug-Eluting Stents
• Fluorocarbon Polymers
• Angioscopy (methods)
• Femoral Artery
• Neointima (pathology)
• Thrombosis (pathology)
• Coronary Vessels (pathology)
• Treatment Outcome