title: Mechanism of edge restenosis after sirolimus-eluting stent implantation.
abstract: OBJECTIVE
  The present study evaluated the mechanism of edge restenosis after sirolimus-eluting stent (SES) implantation using serial (post-intervention and follow-up) intravascular ultrasound (IVUS) analysis.
  
  
  BACKGROUND
  There is little information about the mechanism of edge restenosis after SES implantation.
  
  
  METHODS
  Serial IVUS analysis was performed at 5 mm reference segments immediately proximal and distal to the SES in 25 lesions with edge restenosis. Proximal and distal reference segments were divided into 1 mm subsegments.
  
  
  RESULTS
  Between post-intervention and follow-up IVUS studies, a decrease in external elastic membrane area was observed at the proximal edge. There was a significant increase in plaque & media area in the subsegment closest to the proximal edge. On the other hand, there was an increase in plaque & media area at the distal edge, with no change in external elastic membrane area.
  
  
  CONCLUSIONS
  There may be different mechanisms between proximal and distal edge restenosis after SES implantation. Negative remodeling plays a major role in proximal edge restenosis. On the other hand, intimal hyperplasia may mainly contribute to distal edge restenosis.
authors.affiliation: Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. e.ichimoto@nifty.com
authors.forename: Eiji
authors.initials: E
authors.lastname: Ichimoto
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Kenichirou
authors.initials: K
authors.lastname: Kubo
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Miyayama
authors.forename: Yo
authors.initials: Y
authors.lastname: Iwata
authors.forename: Hideki
authors.initials: H
authors.lastname: Kitahara
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kobayashi
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020123:Sirolimus; D018084:Ultrasonography, Interventional
chemical_list: D020123:Sirolimus