Intra-stent tissue evaluation within bare metal and drug-eluting stents >3 years since implantation in patients with mild to moderate neointimal proliferation using optical coherence tomography and virtual histology intravascular ultrasound

被引：1
作者：
Kitabata, Hironori [1 ]
Loh, Joshua P. [1 ]
Pendyala, Lakshmana K. [1 ]
Omar, Alfazir [1 ]
Ota, Hideaki [1 ]
Minha, Sa'ar [1 ]
Magalhaes, Marco A. [1 ]
Torguson, Rebecca [1 ]
Chen, Fang [1 ]
Satler, Lowell F. [1 ]
Pichard, Augusto D. [1 ]
Waksman, Ron [1 ]
机构：
[1] MedStar Washington Hosp Ctr, Div Cardiol, 110 Irving St,NW Suite 4B-1, Washington, DC 20010 USA
来源：
CARDIOVASCULAR REVASCULARIZATION MEDICINE | 2014年 / 15卷 / 03期
关键词：
Stent; Neoatherosclerosis; Optical coherence tomography; Virtual histology intravascular ultrasound;
D O I：
10.1016/j.carrev.2014.01.009
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Objective: We aimed to compare neointimal tissue characteristics between bare-metal stents (BMS) and druge-luting stents (DES) at long-term follow-up using optical coherence tomography (OCT) and virtual histology intravascular ultrasound (VH-IVUS). Background: Neoatherosclerosis in neointima has been reported in BMS and in DES. Methods: Thirty patients with 36 stented lesions [BMS (n = 17) or DES (n = 19)] >3 years after implantation were prospectively enrolled. OCT and VH-IVUS were performed and analyzed independently. Stents with >= 70% diameter stenosis were excluded. Results: The median duration from implantation was 126.0 months in the BMS group and 60.0 months in the DES group (p < 0.001). Lipid-laden intima (58.8% vs. 42.1%, p = 0.317), thrombus (17.6% vs. 5.3%, p = 0.326), and calcification (35.3% vs. 26.3%, p = 0.559) did not show significant differences between BMS and DES. When divided into 3 time periods, the cumulative incidence of lipid-laden neointima from >3 years to <9 years was similar between BMS and DES (42.9% vs. 42.1%, p = 1.000). Furthermore, it continued to gradually increase over time in both groups. OCT-derived thin-cap fibroatheroma (TCFA) was observed in 17.6% of BMS- and 5.3% of DES-treated lesions (p = 0.326). No stents had evidence of intimal disruption. The percentage volume of necrotic core (16.1% [9.7, 20.3] vs. 9.7% [7.0, 16.5], p = 0.062) and dense calcium (9.5% [3.8, 13.6] vs. 2.7% [0.4, 4.9], p = 0.080) in neointima tended to be greater in BMS-treated lesions. Intra-stent VH-TCFA (BMS vs. DES 45.5% vs. 18.2%, p = 0.361) did not differ significantly. Conclusion: At long-term follow-up beyond 3 years after implantation, the intra-stent neointimal tissue characteristics appeared similar for both BMS and DES. (C) 2014 Elsevier Inc. All rights reserved.
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页码：149 / 155
页数：7
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