title: In-stent neoatherosclerosis and tissue characteristics of restenotic lesions following implantation of second generation drug-eluting stents in unrestricted coronary lesions: Optical frequency domain imaging study.
abstract: BACKGROUND
  Differences in stent platform, polymer coatings, and antirestenotic drugs among the current in use second-generation drug-eluting stents (G2-DESs) may induce significant variations in neointimal response and vascular healing, which may impact the prevalence of neoatherosclerosis (NA) and morphological appearance of the restenotic tissue.
  
  
  RESULTS
  Utilizing Optical frequency domain imaging, two independent reviewers, retrospectively compared the prevalence of neoatherosclerosis (NA), and the morphological differences, and tissue characteristics of 50 G2-DESs in-stent restenosis (ISR) lesions (35 everolimus-eluting stent [22 cobalt-chromium (CoCr), 13 platinum-chromium (PtCr)], and 15 biolimus-eluting stent [BES]) implanted liberally in unrestricted coronary lesions. More than half of the stents were implanted in type C lesions, while 40% of the stents were implanted primarily in lesions with recanalized chronic total occlusion. NA, defined as a neointima formation with the presence of lipids or calcification, was observed in fewer than half (24/50) of all ISR lesions with no significant in-between group differences (41%, 69%, and 40% in CoCr, PtCr, and BES respectively, P = 0.22), nor were there any significant differences in the morphological appearance or tissue characteristics between all G2-DESs subtypes.
  
  
  CONCLUSIONS
  Acknowledging some limitations, our results may suggest that the prevalence of NA and the morphological appearance of restenotic lesions might not differ when G2-DESs are implanted in unrestricted, rather complex, coronary lesions.
authors.affiliation: Faculty of Medicine, Department of Cardiology, Suez Canal University, Ismailia, Egypt.|Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Mahmoud
authors.identifier: http://orcid.org/0000-0001-9071-4784
authors.initials: M
authors.lastname: Sabbah
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.affiliation: Faculty of Medicine, Department of Cardiology, Port-Said University, Port-Said, Egypt.
authors.forename: Azza
authors.initials: A
authors.lastname: El-Eraky
authors.affiliation: Faculty of Medicine, Department of Cardiology, Suez Canal University, Ismailia, Egypt.
authors.forename: Hanan M
authors.initials: HM
authors.lastname: Kamal
authors.affiliation: Faculty of Medicine, Department of Cardiology, Suez Canal University, Ismailia, Egypt.
authors.forename: Ahmed-Tageldien
authors.initials: AT
authors.lastname: Abdellah
authors.affiliation: Faculty of Medicine, Department of Cardiology, Suez Canal University, Ismailia, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El Hawary
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004534:Egypt / Q000453:epidemiology; D000068338:Everolimus / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D011474:Prosthesis Design / Q000145:classification / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus
keywords: drug-eluting stents; in-stent restenosis; neoatherosclerosis; optical frequency domain imaging (OFDI)