Abstract 13952: Spatial Heterogeneity of Neoatherosclerosis and Neovascularization After Stent Implantation: Optical Coherence Tomography Study
Background: Development of neoatherosclerosis (NA) has been reported to be a potential cause of late stent failure. However, the distribution of NA and its relationship with underling plaque characteristics remain unclear.
Methods: We investigated 167 stents (40 bare-metal stents, 84 sirolimus-eluting stents, and 43 everolimus-eluting stents) from 160 patients with optical coherence tomography. Each stent was divided into the proximal (P), middle (M) and distal (D) segment. NA was defined as lipid-laden neointima or calcification inside stent. Stent edge plaque characteristic within 5mm proximal and distal reference segments were evaluated.
Results: NA was more frequent in P and D than in M (P: 19.8% vs. M: 3.6% vs. D: 21%, p<0.001 for P vs. M, p<0.001 for M vs. D). Neovascularization in P and D was also more prevalent compared to that in M (P: 15% vs. M: 5.4 % vs. D: 13.8%, p=0.001 for P vs. M, p=0.001 for M vs. D). NA was more frequent in stents with intraintima neovascularization than without (68.6% vs. 20.5%, p<0.001). The incidence of NA in P and D was higher, when underling plaque was lipid-rich plaque (LRP) (proximal: 69.6% with LRP vs. 11.8% without LRP, p<0.001, and distal: 73.7% with LRP vs. 14.2% without LRP, p<0.001). The distance between most of NAs and neovascularization and stent edge were less than 1mm (Figure).
Conclusion: NA and neovascularization occur more frequently at P and D. NA was associated with underlying LRP and neovascularization, suggesting potential inter-relation between development of NA, and underling plaque characteristics and neovascularization.
- © 2013 by American Heart Association, Inc.