title: Extreme late-phase observation using coronary angioscopy until 7 years after sirolimus-eluting stent implantation.
abstract: BACKGROUND
  Little is known about the very late-phase morphological vessel characteristics within the sirolimus-eluting stent (SES).
  
  
  RESULTS
  We assessed a total of 12 patients with 15 SES implantations who underwent repeat angiographic and angioscopic procedures after 5 and 7 years. The degree of neointimal stent coverage (NSC) was classified as follows: grade 0, uncovered struts; grade 1, visible struts through a thin neointima; or grade 2, invisible struts with complete neointimal coverage. The maximum and minimum NSC grades were evaluated and the existence of in-stent thrombus was also recorded for all patients. The prevalence of a maximum NSC grade of 2 increased and that of a minimum NSC grade of 0 decreased, although there was no significant difference in prevalence between 5 and 7 years. One of four in-stent thrombus identified at 5 years had disappeared from 5 to 7 years and a new thrombus was found in another patient at 7 years. Thus, the incidence of in-stent thrombus did not change from 5 to 7 years. In one case, a thrombus was observed inside the angiographic aneurysmal change, but none of the thrombi were related to adverse events.
  
  
  CONCLUSIONS
  This angioscopic study reported gradual arterial repair and continuous delayed healing associated with subclinical thrombus formation 7 years after SES deployment.
authors.affiliation: aCardiovascular Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba bDepartment of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Shimura
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Masamichi
authors.initials: M
authors.lastname: Takano
authors.forename: Kentaro
authors.initials: K
authors.lastname: Okamatsu
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Inami
authors.forename: Daisuke
authors.initials: D
authors.lastname: Murakami
authors.forename: Ryo
authors.initials: R
authors.lastname: Munakata
authors.forename: Toru
authors.initials: T
authors.lastname: Inami
authors.forename: Osamu
authors.initials: O
authors.lastname: Kurihara
authors.forename: Seiji
authors.initials: S
authors.lastname: Kano
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Seino
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D017546:Angioscopy / Q000379:methods*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000175:diagnosis*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D058426:Neointima / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020123:Sirolimus / Q000494:pharmacology*; D013997:Time Factors; D017539:Tunica Intima / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus