Appearance of Lipid-Laden Intima and Neovascularization After Implantation of Bare-Metal Stents
Appearance of Lipid-Laden Intima and Neovascularization After Implantation of Bare-Metal Stents
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DOI：
10.1016/j.jacc.2009.08.032
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发表时间：
2009-12-29
影响因子：
24
通讯作者：
Mizuno, Kyoichi
中科院分区：
文献类型：
--
作者：
Takano, Masamichi;Yamamoto, Masanori;Mizuno, Kyoichi
ObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjectiveObjective BMS的内部组织被分类为正常新生内膜，其特征在于信号丰富的带而无信号衰减，或脂质铅质内膜，具有显著的信号衰减和弥漫性边界。此外，还评价了内膜破裂和血栓的存在情况。新生血管定义为小泡状或管状结构，并将微血管的位置分为周围性或内膜内。结果正常新生内膜增生均匀，早期未观察到含脂内膜。在晚期阶段，与早期阶段相比，经常发现含脂内膜、内膜破裂和血栓（分别为67% vs. 0%、38% vs. 0%和52% vs. 5%; p < 0.05）。持续性新生血管形成在两个阶段之间的发生率相似。内膜新生血管的出现在晚期比早期更普遍（分别为62%和0%; p < 0.01），并且在含脂质内膜的节段中比在非血管性节段中（分别为79%和29%;结论OCT研究提示BMS内的新生内膜经常转化为脂质，在较长的时间内负载组织，并且新血管形成从驻留到内膜内的扩张有助于新内膜的动脉粥样硬化进展。（J Am科尔心脏病学杂志2010; 55：26-32）（C）美国心脏病学会基金会2010年
Objectives We examined the neointimal characteristics of bare-metal stents (BMS) in extended late phase by the use of optical coherence tomography (OCT).Background The long-term neointimal features after BMS implantation have not yet been fully characterized.Methods Intracoronary OCT observation of BMS segments was performed during the early phase (= 5 years, n = 21) after implantation. Internal tissue of the BMS was categorized into normal neointima, characterized by a signal-rich band without signal attenuation, or lipid-leaden intima, with marked signal attenuation and a diffuse border. In addition, the presence of disrupted intima and thrombus was evaluated. Neovascularization was defined as small vesicular or tubular structures, and the location of the microvessels was classified into peristent or intraintima.Results Normal neointima proliferated homogeneously, and lipid-laden intima was not observed in the early phase. In the late phase, lipid-laden intima, intimal disruption, and thrombus frequently were found in comparison with the early phase (67% vs. 0%, 38% vs. 0%, and 52% vs. 5%, respectively; p < 0.05). Peristent neovascularization demonstrated a similar incidence between the 2 phases. The appearance of intraintima neovascularization was more prevalent in the late phase than the early phase (62% vs. 0%, respectively; p < 0.01) and in segments with lipid-laden intima than in nonlipidic segments (79% vs. 29%, respectively; p = 0.026).Conclusions This OCT study suggests that neointima within the BMS often transforms into lipid-laden tissue during an extended period of time and that expansion of neovascularization from peristent to intraintima contributes to atherosclerotic progression of neointima. (J Am Coll Cardiol 2010; 55: 26-32) (C) 2010 by the American College of Cardiology Foundation