Abstract 14208: Different Response to Balloon Angioplasty among ISR Patients With Homogeneous, Heterogeneous, versus Layered Neointima: An Optical Coherence Tomography Study
Background: Recent optical coherence tomography (OCT) studies have reported that differential morphological characteristics of neointimal tissue within a stent, which were well-correlated with pathological findings. Restenotic structures were assessed qualitatively to characterize the neointimal tissue as 1) homogeneous, 2) heterogeneous, and 3) layered neointima. This study aimed to compare the outcomes of balloon angioplasty for in-stent restenosis (ISR) among three groups using OCT.
Methods and Results: We performed OCT before PCI in 35 patients with ISR. Morphological characteristics of neointimal tissue were evaluated at the minimum lumen area site. Neointimal plaque and stent volume were measured before and after balloon angioplasty using OCT.
The prevalence of homogeneous, heterogeneous, and layered neointima was 54%, 25%, 20%, respectively. The reduction of plaque volume in heterogeneous groups was significantly larger than that in homogeneous and layered groups (31.4 [20.1-84.4] vs. 6.2 [1.2-14.4] vs. 12.4 [3.0-24.3] mm3, p=0.002, Figure1). Likewise, the expansion of lumen volume in heterogeneous group was significantly larger than that in homogeneous group (57.8 [36.5-98.1] vs. 28.7 [14.5-38.3] vs. 54.7 [33.5-80.4] mm3, p=0.01). There was not difference in the incidence of target lesion revascularization among three groups.
Conclusion: The present study showed that larger acute gain was obtained in ISR patients with heterogeneous neointima compared to those with homogeneous or layered neointima.
- Coronary interventions
- Interventional cardiology
- Percutaneous coronary intervention (PCI)
Author Disclosures: T. Yokota: None. T. Higuma: None. T. Endo: None. F. Nishizaki: None. H. Yokoyama: None. M. Yamada: None. H. Tomita: None.
- © 2016 by American Heart Association, Inc.