title: Association of morphologic characteristics on optical coherence tomography and angiographic progression patterns of late restenosis after drug-eluting stent implantation.
abstract: OBJECTIVE
  To gain insight into the pathophysiology of late drug-eluting stent (DES) restenosis.
  
  
  BACKGROUND
  Restenosis of DES has a different time course from that of bare metal stents.
  
  
  METHODS
  Patients who underwent follow-up coronary angiography (CAG) twice (six to nine months and 18 to 24 months) after DES implantation were examined using optical coherence tomography (OCT). All lesions with target lesion revascularization at first follow-up were excluded. Late catch-up was defined as lesions that progressed from less than 50% diameter stenosis (DS) at the first CAG to more than 50% DS at the second CAG. Lesions with the late catch-up were further divided into two groups; lesions with jump-up (less than 25% DS at the first CAG) and lesions with gradual progression (25-50% DS at the first CAG).
  
  
  RESULTS
  Of the 25 patients who had late ISR, 23 patients (10 jump-up/13 gradual progression) were examined with OCT at late follow-up and enrolled in this study. In the qualitative OCT assessment, each ratio of homogeneous, layered, heterogeneous with or without attenuation tissue morphologies were in jump-up group, and gradual progression group were 0% and 15%, 0% and 23%, and 60% and 8%, and 40% and 54%, respectively. All of jump-up group showed heterogeneous restenotic tissue, while 62% of gradual progression group showed heterogeneous restenotic tissue (P = .04).
  
  
  CONCLUSIONS
  These findings suggest different pathophysiology of the late catch-up after DES implantation between the jump-up and gradual progression groups.
authors.affiliation: Division of Cardiology, Tenyoukai Central Hospital, Izumi-cho, Kagoshima city, Kagoshima, Japan. Electronic address: yhclinic@po5.synapse.ne.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamaguchi
authors.affiliation: Division of Cardiology, Tenyoukai Central Hospital, Izumi-cho, Kagoshima city, Kagoshima, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Arikawa
authors.affiliation: Division of Cardiology, Tenyoukai Central Hospital, Izumi-cho, Kagoshima city, Kagoshima, Japan.
authors.forename: Junichiro
authors.initials: J
authors.lastname: Takaoka
authors.affiliation: Division of Cardiology, Tenyoukai Central Hospital, Izumi-cho, Kagoshima city, Kagoshima, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Miyamura
authors.affiliation: Division of Cardiology, Tenyoukai Central Hospital, Izumi-cho, Kagoshima city, Kagoshima, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Atsuchi
authors.affiliation: Division of Cardiology, Tenyoukai Central Hospital, Izumi-cho, Kagoshima city, Kagoshima, Japan.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Ninomiya
authors.affiliation: Division of Cardiology, Tenyoukai Central Hospital, Izumi-cho, Kagoshima city, Kagoshima, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Atsuchi
authors.affiliation: Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Science, Kagoshima University, Kagoshima, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ohishi
authors.affiliation: Department of Cardiology, Toyohashi Heart Center, Toyohashi, Japan.
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Terashima
authors.affiliation: Okinaka Memorial Institute for Medical Research, Tokyo, Japan; Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000503:physiopathology; D018450:Disease Progression; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011237:Predictive Value of Tests; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
keywords: Angioplasty; Atherosclerosis; Imaging