Effect of neointimal tissue morphology on vascular response to balloon angioplasty in lesions with in-stent restenosis after drug-eluting stent deployment: an optical coherence tomography analysis
Effect of neointimal tissue morphology on vascular response to balloon angioplasty in lesions with in-stent restenosis after drug-eluting stent deployment: an optical coherence tomography analysis
复制标题
药物洗脱支架部署后支架内再狭窄病变中新内膜组织形态对球囊血管成形术血管反应的影响：光学相干断层扫描分析
作者：
W. Yamamoto;K. Fujii;S. Otsuji;S. Takiuchi;M. Kakishita;Y. Shimatani;K. Hasegawa;K. Ishibuchi;Hiroto Tamaru;R. Ishii;Shingo Yasuda;Y. Taniguchi;S. Nakabayashi;Hirofumi Kusumoto;Y. Higashino
本研究旨在基于我们新颖的光学相干断层扫描（OCT）分类评估药物洗脱支架（DES）支架内再狭窄（ISR）病变对球囊血管成形术的血管反应，以建立DES植入后ISR病变的最佳治疗策略。通过 OCT 对 DES 植入后总共 104 个 ISR 病灶进行成像，并将其分为以下六种模式：I 型 - 均质高强度组织，II 型 - 信号衰减的异质组织，III 型 - 斑点异质组织，IV 型 - 包含轮廓不清晰的区域且不可见支柱的混合组织，V 型 - 包含清晰轮廓的低强度区域的混合组织，VI 型 - 表面不规则的明亮突出组织。在球囊扩张之前和之后进行系列体积 OCT 分析，以评估球囊血管成形术的血管反应。球囊扩张后，I 型病变中新内膜体积减少最小，而 III 型病变中新内膜体积减少最大。相比之下，I 型病变中支架体积的增加明显多于其他病变。 OCT 的新内膜组织表征使我们能够提供有关血管对球囊扩张的反应的有用信息，这可以影响 DES ISR 病变的治疗策略。
This study aimed to evaluate the vascular response to balloon angioplasty for drug-eluting stent (DES) in-stent restenosis (ISR) lesions based on our novel optical coherence tomography (OCT) classification to establish the optimal treatment strategy for ISR lesions after DES implantation. A total of 104 ISR lesions after DES implantation were imaged by OCT and categorized into the following six patterns: type I—homogeneous high-intensity tissue, type II—heterogeneous tissue with signal attenuation, type III—speckled heterogeneous tissue, type IV—mixed tissue containing poorly delineated region with invisible strut, type V—mixed tissue containing sharply delineated low-intensity region, and type VI—bright protruding tissue with an irregular surface. Serial volumetric OCT analysis was performed before and after balloon dilation to evaluate the vascular response to balloon angioplasty. After balloon dilation, the minimal decrease in neointimal volume was noted in type I lesions and maximal in type III lesions. In contrast, the increase in stent volume was significantly more in type I lesions than others. Neointimal tissue characterization by OCT allows us to provide useful information about the vascular response to balloon dilation, which can influence the therapeutic strategy for DES ISR lesions.
DOI：
10.1016/s0735-1097(02)02598-6
发表时间：
2002-12-18
影响因子：
24
作者：
Chung, IM;Gold, HK;Wight, TN
通讯作者：
Wight, TN