title: Optical coherence tomography and histopathology assessment after implantation of first- and second-generation drug-eluting stents in a porcine coronary model.
abstract: BACKGROUND
  This study directly compared optical coherence tomography (OCT) and histopathology for the assessment of vascular response to first- and second-generation drug-eluting stents. METHODS AND RESULTS: Sirolimus-, everolimus-, and biolimus-eluting stents (SES, EES, and BES, respectively) were randomly implanted into the coronary arteries of 12 porcine. OCT was conducted after implantation: at 1, 3, and 6 months; histopathology was assessed at 3 and 6 months. At 1-month OCT, EES had the highest neointimal area (NA) and lowest neointimal unevenness score (NUS). At 6 months, NA and NUS were equivalent among the stent types. ∆NA from 1 to 6 months was lowest for EES, and ∆NA correlated with the histopathological inflammation score at 6 months, which was highest for SES (P<0.001). The mean signal intensity (MSI) and the attenuation were different for the stent types at 3 months, and were associated with inflammation score. Moderate diagnostic efficiency for measuring MSI was found, with an optimal cut-off of 6.88 predicting a high (≥grade 3) inflammation score.
  
  
  CONCLUSIONS
  EES had the greatest uniformity and the least neointimal proliferation and were associated with less persistent inflammation. OCT provides accurate morphometric data; furthermore, quantitative measurement of the optical properties may help assess histological inflammation, which was more predominantly associated with SES than with EES and BES.
authors.affiliation: Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine.
authors.forename: Noritoshi
authors.initials: N
authors.lastname: Hiranuma
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shinke
authors.forename: Gaku
authors.initials: G
authors.lastname: Nakazawa
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Otake
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsumoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ijichi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kawamori
authors.forename: Ryoji
authors.initials: R
authors.lastname: Nagoshi
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Osue
authors.forename: Junya
authors.initials: J
authors.lastname: Shite
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000818:Animals; D003324:Coronary Artery Disease / Q000473:pathology / Q000601:surgery; D003331:Coronary Vessels / Q000473:pathology*; D004195:Disease Models, Animal; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D007249:Inflammation / Q000209:etiology / Q000473:pathology; D058426:Neointima / Q000473:pathology*; D013552:Swine; D013556:Swine, Miniature; D013997:Time Factors; D041623:Tomography, Optical Coherence