Abstract 16333: Comparison of Cutting Balloon Angioplasty for the Treatment of Restenosis With Bare Metal Stent; Neointimal Hyperplasia Tissue vs Neoatherosclerosis Tissue
Purpose: The morphological characteristics of restenotic tissue with bare metal stent (BMS) in very late in-stent restenosis (VL-ISR) were different from those in early in-stent restenosis (E-ISR) and similar to atherosclerotic plaque which is called neoatherosclerosis. However, the efficacy of cutting balloon angioplasty (CBA) for those different tissues has not been analyzed. The purpose of this study is to compare the efficacy of CBA for ISR of BMS according to the morphologic pattern of restenosis.
Methods: Patients with ISR of BMS were enrolled and were performed optical coherence tomography before intervention. According to the optical coherence tomography (OCT) images and periods after stent implantation, those patients were categorized to 2 group; 1) Neoatherosclerosis group (n=38); angiographcial restenosis was revealed later than 5 years after stent implantation without restenosis within the first year and lipid-like image was shown by OCT image; 2) neointimal hyperplasia (NIH) group (n=62); angiographical restenosis was revealed within first year and OCT image showed homogeneous intima. All cases were treated with CBA and 6 months follow-up angiography was performed and the angiographic findings at 6 months follow-up were compared between the 2 groups.
Results: At 6 months angiographic follow-up, the frequency of re-ISR and target lesion revascularization were significantly higher in neoatherosclerosis group (57.8% vs 35.4%, 44.7% vs 24.2%; p<0.05). Re-occlusion was revealed only 1 case in neoahterosclerosis group (p=0.31). There was no significant differences about late loss (0.87±0.56mm vs 0.74±0.75mm, p=0.39)
Conclusion: The treatment with CBA for BMS VL-ISR lesion with neoatherosclesosis could not show similar efficacy compare to those for BMS E-ISR lesion with NIH tissue.
- © 2013 by American Heart Association, Inc.