Abstract 14818: Comparison of Morphologic Characteristics of Neointimal Tissue by Optical Coherence Tomography between the Lesions with and without In-Stent Restenosis
Backgrounds: Clarification of characteristics of neointimal tissue would be an essential step to understand the patho-physiology of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation.
Methods: Using optical coherence tomography (OCT), we compared the morphologic characteristics of in-stent neointimal tissue between the lesions with and without ISR after DES implantation. DES consisted of sirolimus-eluting stent in 52 lesions, paclitaxel-eluting stent in 57, zotarolimus-eluting stent in 84, and everolimus-eluting stent in 32. ISR was defined as ≥ 50% diameter stenosis at the follow-up angiogram. The lesions of ≥ 10% burden of neointimal tissue (=100×neointima area/stent area) by OCT measurements were included in this study. Qualitative OCT analysis of neointimal tissues included the assessment of tissue structure, backscatter, visible microvessels, and presence of intraluminal material.
Results: A follow-up OCT (mean follow-up duration: 12.0±10.5 months) was performed in 209 patients with 225 lesions (192 lesions without ISR and 33 lesions with ISR). Heterogeneous or layered tissue structure, low backscatter and microvessels were more frequently observed in the ISR lesions than in the non-ISR lesions (78.8% vs. 22.9%, p<0.001, 60.6% vs. 20.8%, p<0.001, and 48.5% vs. 5.7%, p<0.001, respectively, Table 1). The independent predictors for heterogeneous or layered neointimal tissue structure were an increase in the burden of neointimal tissue (OR=1.218, 95% CI=1.096–1.354, p<0.001), lumen area (OR=4.672, 95% CI=1.371–15.914, p=0.014), and hypertension (OR=0.415, 95% CI=0.186–0.926, p=0.032). Conclusion, this follow-up OCT study showed that the morphologic characteristics of neointimal tissues may be different between the ISR and the non-ISR lesions.
- © 2010 by American Heart Association, Inc.