Open AccessNeointimal coverage after second generation drug-eluting stent implantation has a relationship with pre-existing atherosclerotic lesion characteristics
Author(s) -
Yohta Nomoto,
Masashi Nakagawa,
Nobuyuki Shirai,
Keiko Kajio,
Kazuki Mizutani,
Takanori Yamazaki,
Kenichi Sugioka,
Kimio Kamimori,
Makiko Ueda,
Yasuhiro Izumiya,
Minoru Yoshiyama
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000017097
Subject(s) - medicine , neointima , restenosis , stent , target lesion , interquartile range , lesion , drug eluting stent , percutaneous coronary intervention , radiology , optical coherence tomography , asymptomatic , cardiology , surgery , myocardial infarction
The relationship between preexisting atherosclerotic lesion characteristics and neointimal thickness after second-generation drug-eluting stent (DES) placement is still unknown. Thus, we evaluated that relationship using optical coherence tomography (OCT). A single-center, retrospective, observational study was conducted. Patients with stable angina or asymptomatic myocardial ischemia who received percutaneous coronary intervention for a de novo lesion using a second-generation DES under frequency domain OCT guidance and underwent follow-up coronary angiography (CAG) and OCT between December 2010 and December 2015 were included. The relationship between the neointimal thickness on the stent strut and the plaque characteristics was retrospectively evaluated using OCT immediately after stent implantation and at the time of follow-up CAG. We analyzed 3459 struts from 20 stents in 15 patients. The mean follow-up period was 264 days. In the follow-up study, no angiographic in-stent restenosis was found. Of the 3459 struts, 3315 (95.8%) were covered with neointima. The median neointimal thicknesses of the stent struts on calcified, fibrous, and lipid-rich lesions were 20 μm (interquartile range [IQR], 10–50 μm), 70 μm (40–140 μm; P < .001), and 90 μm (50–170 μm; P < .001), respectively. These differences were observed regardless of the type of second-generation DES used. Most of the stent struts were covered with neointima. The neointimal thickness after the second-generation DES implantation had a close relationship with the preexisting atherosclerotic lesion characteristics. In this study, we found differences in arterial healing processes due to underlying plaque; therefore, evaluating the lesion characteristics by OCT may predict the risk for future restenosis and thrombosis.