Abstract 10800: Optical Coherence Tomography and Histopathological Assessment of Delayed Arterial Healing After Drug-Eluting Stent Implant Using in Pig Coronary Model
Background: Delayed healing such as persistent inflammation and fibrin deposition after drug-eluting stent (DES), which might be related to the late cardiac events has been reported in several pathological studies. However, comparison between clinical imaging modality and histological findings of neointima are still largely unknown. The purpose of this study is to assess delayed healing after DES implantation using Optical Coherence Tomography (OCT) and histopathology in pig model.
Method: Sirolimus eluting stent (SES, n=6) and bare metal stent (BMS n=8) were implanted in the pig coronaries. One month after implantation SES and BMS were evaluated with OCT. OCT texture pattern of neointima was classified into three categories; Homogeneous high signal type (Homo), layered type (adluminal high signal and abluminal low signal layer: Layered) and heterogeneous type (high signal containing multiple low signal area: Hetero). Average OCT intensity of neointimal area was also measured. Hearts were harvested for histopathologic scoring of inflammation (Inf) and intramural thrombus (IT).
Result: SES showed higher frequency of Hetero (Homo 16.7%, Layered 5.6%, Hetero 77.8%), while BMS revealed predominantly Homo (Homo 79.2%, Layered 12.5%, Hetero 8.3%, P<0.01 vs SES). OCT intensity of Homo (6.90±0.36W) is higher than that of Layered (6.43±0.21W P=0.0097) and Hetero (6.49±0.28W P=0.0003). Histopathogy scoring for IT and Inf were higher in Hetero (2.25±0.77 and 1.75±0.93) compared with that in Layered (1.25±1.26 and 1.00±0 P=0.0157, P=0.0307 respectively) and in Homo (1.09±0.53 and 1.05±0.21 P<0.0001, P=0.0009 respectively), resulting in higher IT and Inf in SES (2.39±0.70 and 1.72±0.89) than BMS (0.92±0.28 and 1.00±0 P<0.0001, P=0.0003 respectively).
Conclusion: Heterogeneous pattern including multiple low signal area assessed by OCT image is associated with histological inflammation and intramural thrombus, which is characterized by delayed healing in SES.
- © 2010 by American Heart Association, Inc.