The impact of tissue characterization for in-stent restenosis with optical coherence tomography during excimer laser coronary angioplasty.
The impact of tissue characterization for in-stent restenosis with optical coherence tomography during excimer laser coronary angioplasty.
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DOI：
10.1007/s12928-018-0543-8
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发表时间：
2019-04
影响因子：
3.2
通讯作者：
Nakajima S
中科院分区：
文献类型：
--
作者：
Hashimoto S;Takahashi A;Mizuguchi Y;Yamada T;Taniguchi N;Hata T;Nakajima S
我们旨在评价药物洗脱支架（DES）时代准分子激光冠状动脉成形术（ELCA）期间光学计算机断层扫描（OCT）组织表征对支架内再狭窄（ISR）的影响。根据组织特征的差异，ELCA对ISR的影响尚不清楚。53处ISR病变（7枚裸金属支架和46枚药物洗脱支架）采用ELCA导管治疗。ELCA后，使用评分球囊或非顺应性球囊进行球囊扩张。通过应用药物涂层球囊完成了手术。使用OCT进行了三次组织定征和管腔测量：（1）经皮冠状动脉介入治疗（PCI）前，（2）ELCA后，（3）手术后。病变分为同质、分层和混合组。在PCI后6-12个月进行随访血管造影。PCI前最小管腔面积（MLA）无显著差异。ELCA后3组间MLA差异有统计学意义（均质组：1.75 ± 0.84 mm 2，分层组：1.72 ± 0.45 mm 2，混合组：2.24 ± 0.70 mm 2，P = 0.048）。混合组的最终MLA大于均质组（P = 0.028）。随访血管造影中的二元再狭窄（均匀组55.5%，分层组33.3%，混合组33.3%; P = 0.311）和靶病变血运重建率（均匀组30.0%，分层组23.8%，混合组25.0%; P = 0.923）无显著差异。OCT的组织表征可以预测ELCA和球囊血管成形术在急性期治疗ISR的有效性。
We aimed to evaluate the impact of tissue characterization for in-stent restenosis (ISR) with optical computed tomography (OCT) during excimer laser coronary angioplasty (ELCA) in the drug-eluting stent (DES) era. The effect of ELCA for ISR according to differences in tissue characteristics is unclear. Fifty-three ISR lesions (7 bare metal stents and 46 drug-eluting stents) were treated with an ELCA catheter. After ELCA, balloon dilatation with either the scoring or non-compliant balloons was conducted. The procedure was completed by applying a drug-coated balloon. Tissue characterization and lumen measurement with OCT were performed thrice: (1) before percutaneous coronary intervention (PCI), (2) after ELCA, and (3) and after the procedure. Lesions were categorized into the homogenous, layered, and mixed groups. Follow-up angiograms were conducted 6–12 months after PCI. No significant differences in minimal lumen area (MLA) were observed before PCI. A significant difference was observed in MLA after ELCA among the three groups (homogeneous group: 1.75 ± 0.84 mm2, layered group: 1.72 ± 0.45 mm2, mixed group: 2.24 ± 0.70 mm2, P = 0.048). Final MLA was larger in the mixed group than in the homogeneous group (P = 0.028). No significant difference was observed in binary restenosis in the follow-up angiogram (homogeneous group 55.5%, layered group 33.3%, mixed group 33.3%; P = 0.311) and the target lesion revascularization rate (homogeneous 30.0%, layered 23.8%, mixed 25.0%; P = 0.923). Tissue characterization by OCT may predict the efficacy of ELCA and balloon angioplasty for ISR during the acute phase.
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影响因子：
3.3
作者：
Nagoshi, Ryoji;Shinke, Toshiro;Hirata, Ken-ichi
通讯作者：
Hirata, Ken-ichi
DOI：
10.1161/circinterventions.111.967802
发表时间：
2012-12-01
影响因子：
5.6
作者：
Stolker, Joshua M.;Cohen, David J.;Kleiman, Neal S.
通讯作者：
Kleiman, Neal S.
影响因子：
1.7
作者：
Arikawa, Ryo;Yamaguchi, Hiroshi;Kaneda, Hideaki
通讯作者：
Kaneda, Hideaki
影响因子：
2.8
作者：
Kim, Young-Hak;Lee, Bong-Ki;Park, Seung-Jung
通讯作者：
Park, Seung-Jung
影响因子：
39.3
作者：
Radke, PW;Kaiser, A;Sigwart, U
通讯作者：
Sigwart, U