title: Clinical significance of low signal intensity area surrounding stent struts identified by optical coherence tomography.
abstract: Previous intravascular ultrasound studies have shown that echolucent neointimal hyperplasia occasionally appears after bare-metal stent (BMS) or sirolimus-eluting stent (SES) implantation. Optical coherence tomography (OCT) studies have also demonstrated that paclitaxel-eluting stent (PES) restenosis exhibited similar images showing low signal intensity areas (LSIA) surrounding stent struts and three-layer appearance (TLA). The aim of the present study was to investigate the clinical significance of LSIA on OCT images in various types of stents. Fifty nine consecutive patients who underwent scheduled follow-up coronary angiography and OCT were enrolled. There was no significant difference in the prevalence of LSIA among the 3 stent groups (BMS 30%, SES 19%, PES 28%, P = 0.70). LSIA thickness was larger in the PES group than in the other stent groups (BMS 0.51 ± 0.21 mm, SES 0.35 ± 0.06 mm, PES 0.87 ± 0.19 mm, P < 0.01). The ratio of LSIA thickness to the neointimal thickness was also larger in PES compared with other stents (BMS 53 ± 9 %, SES 57 ± 8 %, PES 77 ± 5 %, P < 0.01). Also, LSIA thickness in patients with in-stent restenosis (ISR) was significantly larger than in those without ISR (0.37 ± 0.37 mm versus 0.12 ± 0.26 mm, P = 0.048). Our results suggest that LSIA might be involved in excessive neointimal formation, and that the healing response after PES implantation might be different from BMS or SES.
authors: Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Kohei
authors: K
authors: Ishibashi
authors: Atsushi
authors: A
authors: Tanaka
authors: Hironori
authors: H
authors: Kitabata
authors: Takashi
authors: T
authors: Kubo
authors: Manabu
authors: M
authors: Kashiwagi
authors: Kenichi
authors: K
authors: Komukai
authors: Yasushi
authors: Y
authors: Ino
authors: Takashi
authors: T
authors: Tanimoto
authors: Kazushi
authors: K
authors: Takemoto
authors: Shigeho
authors: S
authors: Takarada
authors: Kumiko
authors: K
authors: Hirata
authors: Masato
authors: M
authors: Mizukoshi
authors: Toshio
authors: T
authors: Imanishi
authors: Takashi
authors: T
authors: Akasaka
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy; D023903:Coronary Restenosis / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000175:diagnosis; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007564:Japan; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000473:pathology*; D017063:Outcome Assessment, Health Care; D017239:Paclitaxel / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000473:pathology*; D011446:Prospective Studies; D020123:Sirolimus / Q000627:therapeutic use*; D015607:Stents / Q000009:adverse effects / Q000145:classification; D041623:Tomography, Optical Coherence / Q000379:methods*; D050257:Tubulin Modulators / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D050257:Tubulin Modulators; D017239:Paclitaxel; D020123:Sirolimus