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- Dokumenttyp:
- Article; Journal Article
- Autor(en):
- Xhepa, Erion; Byrne, Robert A; Rivero, Fernando; Rroku, Andi; Cuesta, Javier; Ndrepepa, Gjin; Kufner, Sebastian; Valiente, Teresa Bastante; Cassese, Salvatore; Garcia-Guimaraes, Marcos; Lahmann, Anna Lena; Rai, Himanshu; Schunkert, Heribert; Joner, Michael; Pérez-Vizcayno, María José; Gonzalo, Nieves; Alfonso, Fernando; Kastrati, Adnan
- Titel:
- Qualitative and quantitative neointimal characterization by optical coherence tomography in patients presenting with in-stent restenosis.
- Abstract:
- AIMS: To describe optical coherence tomography (OCT) findings in patients with in-stent restenosis (ISR) and determine predictors of neointimal patterns and neoatherosclerosis. METHODS AND RESULTS: Patients undergoing OCT prior to PCI for ISR in three European centres were included. Analyses were performed in a core laboratory. Qualitative and quantitative [gray-scale signal intensity (GSI)] neointima analyses were performed on a per quadrant basis. A total of 107 patients were included. Predominantly homogeneous lesions included 4.5% (0.0-14.3) non-homogeneous quadrants, while predominantly non-homogeneous ones included 28.1% (20.3-37.5) homogeneous quadrants. Mean GSI values differed significantly between homogeneous [108.4 (92.5-123.6)], non-homogeneous [79.9 (61.2-95.9)], and neoatherosclerosis [88.3 (72.8-104.9)] quadrants (p < 0.001 for all comparisons). Stent underexpansion was observed in 48.5% and 61.1% of lesions, respectively (p = 0.225). Female sex and maximal neointimal thickness independently correlate with a non-homogeneous pattern, while angiographic pattern and diabetes mellitus inversely correlate with such pattern. Time from index stenting procedure was the only independent predictor of neoatherosclerosis. CONCLUSIONS: Different neointimal patterns coexist in a significant proportion of ISR lesions. GSI values differ significantly between neointimal categories. Neoatherosclerosis is a time-dependent phenomenon, displaying different time courses in DES compared to BMS, with earlier appearance in the former group. Stent underexpansion is a frequent finding in patients with ISR.
- Zeitschriftentitel:
- Clin Res Cardiol
- Jahr:
- 2019
- Band / Volume:
- 108
- Heft / Issue:
- 9
- Seitenangaben Beitrag:
- 1059-1068
- Volltext / DOI:
- doi:10.1007/s00392-019-01439-5
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/30783752
- Print-ISSN:
- 1861-0684
- TUM Einrichtung:
- Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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