title: Qualitative and quantitative assessment of stent restenosis by optical coherence tomography: comparison between drug-eluting and bare-metal stents.
abstract: BACKGROUND
  We hypothesized that the tissue components of in-stent restenosis (ISR) might differ between drug-eluting stents (DES) and bare-metal stents (BMS) and that these differences could be distinguished by qualitative and quantitative optical coherence tomography (OCT) analyses.
  
  
  RESULTS
  One-hundred and twenty-two initial ISR lesions (sirolimus-eluting stents: n=28; paclitaxel-eluting stents: n=51; BMS: n=43) were evaluated with OCT. Based on their OCT appearance, the lesions were classified as homogeneous, layered or heterogeneous. The optical properties of backscatter, attenuation and signal intensity of the neointimal tissue (NIT) were quantified. To evaluate the vascular response after balloon angioplasty (BA), the rate of reduction of the NIT area (NITA) was calculated (NITA before - after BA/NITA before BA at the minimum lumen cross-sectional area). Among the morphologic OCT patterns, the layered type was predominant with DES, whereas lesions were homogeneous with BMS (P<0.001). Backscatter and signal intensity were significantly higher with BMS (P<0.05 and P<0.001 respectively). The NITA reduction rate was significantly greater in the layered and heterogeneous groups than in the homogeneous group (P<0.01).
  
  
  CONCLUSIONS
  The morphologic OCT patterns of the NIT in ISR differed significantly between DES and BMS, probably reflecting pathologic differences. Layered and heterogeneous tissues might respond better than homogeneous tissue to simple balloon dilatation, suggesting a possible direction for OCT-based ISR treatment strategies.
authors.affiliation: Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Nagoshi
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shinke
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Otake
authors.forename: Junya
authors.initials: J
authors.lastname: Shite
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsumoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawamori
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Amane
authors.initials: A
authors.lastname: Kozuki
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Hariki
authors.forename: Takumi
authors.initials: T
authors.lastname: Inoue
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ohsue
authors.forename: Yu
authors.initials: Y
authors.lastname: Taniguchi
authors.forename: Masamichi
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Ryo
authors.initials: R
authors.lastname: Nishio
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Hiranuma
authors.forename: Akihide
authors.initials: A
authors.lastname: Konishi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kinutani
authors.forename: Naoki
authors.initials: N
authors.lastname: Miyoshi
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Takaya
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yamada
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Yasaka
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Hayashi
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kato
authors.forename: Makoto
authors.initials: M
authors.lastname: Kadotani
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ohnishi
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000453:epidemiology* / Q000473:pathology* / Q000517:prevention & control; D023921:Coronary Stenosis / Q000628:therapy; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008670:Metals; D008875:Middle Aged; D058426:Neointima / Q000000981:diagnostic imaging / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D008670:Metals; D017239:Paclitaxel; D020123:Sirolimus