title: Evaluation of the peri-strut low intensity area following sirolimus- and paclitaxel-eluting stents implantation: insights from an optical coherence tomography study in humans.
abstract: BACKGROUND
  Recent pathological studies have demonstrated that peri-strut low intensity area (PLIA) seen on optical coherence tomography (OCT) imaging represents the presence of fibrinogen and/or extracellular matrix. We sought to assess the clinical prevalence of PLIA and its relation to neointimal proliferation after the implantation of sirolimus- (SES) and paclitaxel-eluting stents (PES) in humans.
  
  
  METHODS
  Seventy patients underwent 6-months follow-up OCT after SES (43 stents) or PES (37 stents) implantation. PLIA was defined as a region around stent struts with homogenous lower intensity than surrounding tissue on OCT images without signal attenuation. The incidence of stent struts with PLIA (+PLIA struts) was calculated as the number of +PLIA struts/number of all struts (%).
  
  
  RESULTS
  PES showed a higher incidence of stents with PLIA than SES (86% vs. 58%; p=0.005) with a higher prevalence of +PLIA struts (27.8±21.9% vs. 10.9±11.0%; p=0.0008). SES with PLIA showed a significantly greater neointimal thickness (NIT) than SES without PLIA (p=0.02), while PES showed a similar tendency (p=0.19). In a detailed strut basis analysis, average NIT on +PLIA struts were significantly greater than that on -PLIA struts in both SES and PES. In addition, average NIT was positively correlated with the prevalence of +PLIA struts (SES: Rho=0.73; p<0.0001, PES: Rho=0.58, p=0.0005) in both stents.
  
  
  CONCLUSIONS
  The prevalence of PLIA was significantly higher in PES than in SES. The presence and extent of PLIA might be associated with intimal thickening after 1st-generation DES implantation.
authors.affiliation: Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Otake
authors.forename: Junya
authors.initials: J
authors.lastname: Shite
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Ikeno
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shinke
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Teramoto
authors.forename: Naoki
authors.initials: N
authors.lastname: Miyoshi
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Honda
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Fitzgerald
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000188:drug therapy; D054855:Drug-Eluting Stents / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D017239:Paclitaxel / Q000008:administration & dosage*; D011859:Radiography; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D041623:Tomography, Optical Coherence / Q000379:methods / Q000592:standards*; D016896:Treatment Outcome
chemical_list: D017239:Paclitaxel; D020123:Sirolimus