title: Histopathological findings of new in-stent lesions developed beyond five years.
abstract: We analyzed 14 cases of new lesions inside implanted bare-metal stents. In every case, there was no angiographic restenosis within 3 years, but a new lesion was observed inside a stented segment at long-term follow-up (>5 years). Fourteen cases were evaluated: 9 with Wiktor stents, 2 with Palmaz-Schatz stents, and 3 with ACS Multilink stents. The interval from stent implantation to follow-up angiography was 63-147 months (89 +/- 23). Thirteen lesions were treated by percutaneous coronary intervention (PCI) and stenotic tissue was obtained by directional coronary atherectomy (DCA) in 10 cases. All retrieved samples were composed of newly developed atherosclerosis facing the healed neointimal layer, and four samples showed histopathological findings of acute coronary syndrome. Stent struts were retrieved in four cases and no inflammation was observed surrounding them. Qualitative and quantitative analysis of stent struts was performed in two cases that showed no metal corrosion. These findings suggest that new atherosclerotic progression occurred inside the implanted stent without peristrut inflammation.
authors.affiliation: Department of Cardiology, Shiga Medical Center for Adults, Shiga, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Hideo
authors.initials: H
authors.lastname: Tamai
authors.forename: Eisho
authors.initials: E
authors.lastname: Kyo
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kosuga
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ikeguchi
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Hata
authors.forename: Masaharu
authors.initials: M
authors.lastname: Okada
authors.forename: Shinya
authors.initials: S
authors.lastname: Fujita
authors.forename: Takafumi
authors.initials: T
authors.lastname: Tsuji
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Takeda
authors.forename: Rei
authors.initials: R
authors.lastname: Fukuhara
authors.forename: Yuetsu
authors.initials: Y
authors.lastname: Kikuta
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Motohara
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ono
authors.forename: Eiji
authors.initials: E
authors.lastname: Takeuchi
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D004691:Endarterectomy / Q000379:methods; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D012086:Reoperation; D015607:Stents; D013997:Time Factors