Abstract 11653: Impact of Optical Coherence Tomography Tissue Appearance and Properties for Restenosis of Drug-Eluting Stents on Recurrent In-Stent Restenosis Following Balloon Angioplasty
Background: Different mechanisms of drug-eluting stent (DES) restenosis have been suggested in histopathological studies. We assessed the influence of restenotic tissue characteristics of DES evaluated by optical coherence tomography (OCT) on recurrent restenosis following balloon angioplasty.
Methods and Results: Thirty-two angiographically documented in-stent restenotic lesions of four types of DES (sirolimus-DES: 72%, paclitaxel-DES: 22%, zotarolimus-DES: 3%, everolimus-DES: 3%) in 25 patients were included. Before balloon angioplasty, OCT appearance of restenotic tissue was qualitatively assessed, and tissue intensities were quantitatively measured using a dedicated OCT software at 0.2mm intervals. Minimal lumen areas were measured at pre- and post-procedure. Recurrence of binary restenosis was assessed at mid-term angiographic follow-up. Recurrent restenosis occurred in 21/32 lesions at 6.0±2.0 months. Patient and lesion characteristics were similar between restenotic lesions and non-restenotic lesions. OCT tissue appearances, such as homogeneous (57% vs. 82%), heterogeneous (24% vs. 9%) and highly attenuated (19% vs. 9%) were similar in restenotic lesions vs. non-restenotic lesions (p=0.4). Minimal lumen area at pre-procedure was similar in restenotic lesions vs. non-restenotic lesions (1.61±0.86cm2 vs. 2.24±1.09cm2, p=0.08), but it was smaller in restenotic lesions vs. non-restenotic lesions at post-procedure (4.36±1.50cm2 vs. 5.67±1.84cm2, p=0.04). Averages of minimal, mean and maximal optical intensities were similar in restenoric lesions vs. non-restenotic lesions (3.53±1.78 vs. 3.45±1.82, 6.01±1.22 vs. 6.06±1.03 and 8.17±1.00 vs. 8.19±0.95, respectively, p>0.5).
Conclusions: Different types of restenotic tissue of DES identified by OCT may not predict recurrent restenosis after balloon angioplasty, although smaller minimal lumen area immediately after ballooning correlated with recurrent restenosis.
- © 2011 by American Heart Association, Inc.