Abstract 11398: Difference of Tissue Characteristics of Restenosis Lesion Between Drug-Eluting Stent and Bare-Metal Stent : Optical Coherence Tomography Analysis
Aim: Drug-eluting stents (DES) dramatically reduced the incidence of in-stent restenosis (ISR). However ISR has not been completely resolved and its pathophysiology is poorly understood. Optical coherence tomography (OCT) is a novel intravascular imaging modality that can produce in vivo high resolution images of the coronary artery, providing new insights into the characteristics of stent restenotic tissue structure. The purpose of this investigation was to evaluate the presence of different morphologic characteristics in DES and BMS restenosis lesions.
Method: Seventy patients with angiographic ISR were enrolled this study. OCT observation of BMS segments was performed during early phase (< 1 year, n=30), and DES segments was performed during early phase (<1 year, n=30) and late phase (>1 year, n=10). Qualitative OCT analysis included assessment of tissue structure, lumen shape, and the presence of visible microvessels and intraluminal material. In addition, heterogeneous image of tissue structure was classified to patchy and high echolucent pattern (type1) or layered pattern (type2).
Result: OCT findings of 40 DES ISR lesions compared to those of 30 EISR lesions. The incidence of heterogeneous intima was significant higher in DES group than BMS group (60% vs 0%; p<0.001). Although there was no significant difference between the 2 groups about lumen shape and incidence of peristent microvessels and intraluminal materials, the appearance of intraintima microvessels was more prevalent in DES group (25% vs 0%, p<0.05). In DES group, there were no significant differences between early phase and late phase about these qualitative parameters. However, heterogeneous image was different between the 2 phases (type1 47.3% vs 0%, type2 52.7% vs 100%; p=0.05).
Conclusion: The morphological characteristics of tissue structure with ISR of DES were significantly different from those of BMS. These findings might suggest different restenosis mechanism of DES and BMS.
- © 2010 by American Heart Association, Inc.