Abstract 14913: Difference of Tissue Characteristics in In-stent Re-restenosis Lesions: a Comparison Between Paclitaxel-eluting Balloon Dilatation and Plain Old Balloon Angioplasty for In-stent Restenosis Lesions After Drug-eluting Stent Implantation
Background: The morphological assessment of neointimal tissue is highly significant to clarify the pathophysiology of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation. Recently, the assessments of in-stent restenotic tissue using optical coherence tomography (OCT) were performed and the differences of morphological characteristics among various DESs were reported. However, little was known about the re-restenotic tissue characteristics after drug-eluting balloon dilatation. The objective of this study was to clarify the difference of tissue characteristics in in-stent re-restenosis lesions between paclitaxel-eluting balloon (PEB) dilatation and plain old balloon angioplasty (POBA) for ISR lesions after DES implantation.
Methods and Results: Between February 2008 and April 2011, we performed PCI using optical coherence tomography (OCT) for in-stent re-restenosis lesions after PEB dilatation in 14 patients (PEB group) and those after POBA in 18 patients (POBA group). The morphological assessment of neointimal tissue at the minimum lumen area site, including restenotic tissue structure (homogeneous or heterogeneous), restenotic tissue backscatter, visible microvessels, lumen shape, and the presence of intraluminal material, was performed. The patients were 26 men and 6 women, and the mean age was 69.5±10.4 years. The representative cases of PEB group and POBA group were shown in figure A and B, respectively. Heterogeneous intima was observed more frequently in the PEB group than in the POBA group (71.4% vs. 33.3%, p<0.05). There was no significant difference in other factors between two groups.
Conclusions: The pathophysiology of in-stent re-restenosis after PEB dilatation might be different from that after POBA.
- © 2011 by American Heart Association, Inc.