In-stent neointimal characteristics and late neointimal response after drug-eluting stent implantation: A preliminary observation
In-stent neointimal characteristics and late neointimal response after drug-eluting stent implantation: A preliminary observation
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DOI：
10.1016/j.jjcc.2015.07.002
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发表时间：
2016-05-01
影响因子：
2.5
通讯作者：
Uemura, Shiro
中科院分区：
文献类型：
--
作者：
Fukuhara, Kenzo;Okura, Hiroyuki;Uemura, Shiro
背景：药物洗脱支架（DES）植入后进行性新生内膜增生可能导致晚期再狭窄和/或新动脉粥样硬化。不同组织特性的晚期新生内膜反应可能不同。本研究的目的是评估支架内新生内膜特征对晚期新生内膜反应的影响，DES implantation.Methods：系列（中位数270天和中位数551天后支架植入）光学相干断层扫描（OCT）检查进行了42支架病变26例。根据第1次随访时的OCT外观，将支架内新生内膜组织分类为同质或异质新生内膜。结果：首次随访时，内膜均匀性病变22例（52%），内膜不均匀性病变20例（48%）。随访期间，新生内膜均匀的病变中NIA显著降低（1.8 +/- 0.93 mm（2）至1.5 +/- 0.88 mm（2），p < 0.001）。另一方面，具有不均匀新生内膜的病变中的NIA没有显著变化（2.7 +/- 1.8 mm（2）至2.8 +/- 1.6 mm（2），p = 0.658）。均质新生内膜是晚期新生内膜消退的唯一预测因子（晚期新生内膜消退定义为首次随访时的NIA-第二次随访时的NIA
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