Qualitative and quantitative neointimal characterization by optical coherence tomography in patients presenting with in-stent restenosis

Xhepa, Erion; Byrne, Robert A.; Rivero, Fernando; Rroku, Andi; Cuesta, Javier; Ndrepepa, Gjin; Kufner, Sebastian; Valiente, Teresa; Cassese, Salvatore; García-Guimarães, Marcos; Lahmann, Anna Lena; Rai, Himanshu; Schunkert, Heribert; Joner, Michael; Pérez-Vizcayno, Marı́a José; Gonzalo, Nieves; Alfonso, Fernándo; Kastrati, Adnan

doi:10.1007/s00392-019-01439-5

Cited by 15 publications

(13 citation statements)

References 25 publications

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“…The homogeneous type mainly composed of the smooth muscle cells with collagen fibers is predominant in the BMS-ISR lesions, while layered type that comprises proteoglycans, inflammatory cells, and fibrinoids is the main pattern of the DES-ISR lesions. Besides, neoatherosclerosis occurs more frequently and earlier in DES-ISR lesions than in BMS-ISR lesions [ 27 , 28 ]. Nagoshi et al [ 26 ] evaluated the efficiency of BA for homogeneous and layered lesions, and the results showed that after BA, reduction in neointimal tissue area was significantly smaller in homogeneous lesions than in layered lesions, suggesting that layered ISR tissue may respond better to BA than those homogeneous ISR tissue.…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Drug-Eluting versus Bare-Metal In-Stent Restenosis after the Treatment of Drug-Eluting Stent or Drug-Eluting Balloon: A Systematic Review and Meta-Analysis

Yang

Liu

et al. 2020

Journal of Interventional Cardiology

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Background. Although drug-eluting stents (DES) have reduced the rates of in-stent restenosis (ISR) compared with bare-metal stents (BMS), DES related ISR (DES-ISR) still occurs and outcomes of DES-ISR remain unclear. The objective of this meta-analysis was to investigate the long-term clinical outcomes of patients with DES-ISR compared with patients with BMS related ISR (BMS-ISR) after the treatment of DES or drug-eluting balloon (DEB). Methods and results. We searched the literature in the main electronic databases including PUBMED, EMBASE, Cochrane Library, and Web of Science. The primary endpoints were target lesion revascularization (TLR) and target vessel revascularization (TVR). The secondary endpoints included all cause death (ACD), cardiac death (CD), myocardial infarction (MI), stent thrombosis or re-in-stent restenosis (ST/RE-ISR), and major adverse cardiovascular events (MACEs). A total of 19 studies with 6256 participants were finally included in this meta-analysis. Results showed that the rates of TLR (P<0.00001), TVR (P<0.00001), CD (P=0.02), ST/RE-ISR (P<0.00001), and MACEs (P<0.00001) were significantly higher in the DES-ISR group than in the BMS-ISR group. No significant differences were found between the two groups in the rates of MI (P=0.05) and ACD (P=0.21). Conclusions. Our study demonstrated that patients with DES-ISR had worse clinical outcomes at the long-term follow-up than patients with BMS-ISR after the treatment of DES or DEB, suggesting that DES and DEB may be more effective for BMS-ISR than that for DES-ISR. Positive prevention of DES-ISR is indispensable and further studies concentrating on detecting the predictors of outcomes of DES-ISR are required.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcomes of Drug-Eluting versus Bare-Metal In-Stent Restenosis after the Treatment of Drug-Eluting Stent or Drug-Eluting Balloon: A Systematic Review and Meta-Analysis

Yang

Liu

et al. 2020

Journal of Interventional Cardiology

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“…This means that neoatherosclerosis was not only significantly more frequent in DES-treated patients but also occurred at shorter time intervals after stenting relative to matched BMS groups 9 . Neoatherosclerosis is associated with late-stent failure such as in-stent restenosis or stent-thrombosis 9,14,15 Recently, a large registry investigating stent-thombosis by OCT found that very-late stent thrombosis (VLST) is caused by neoatherosclerosis in approximately 31% of cases, representing the predominant causative factor 14 .…”

Section: Discussionmentioning

confidence: 99%

Assessment of a pro-healing stent in an animal model of early neoatherosclerosis

Nicol

Lutter

Bulin

et al. 2020

Sci Rep

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Background: neoatherosclerosis represents an accelerated manifestation of atherosclerosis in nascent neointima after stenting, associated with adverse events. We investigated whether improved reendothelialization using RGD-coated stents results in diminished vascular permeability and reduced foam cell formation compared to standard DeS in atherosclerotic rabbits. Methods and Results: neointimal foam cell formation was induced in rabbits (n = 7). Enhanced endothelial integrity in RGDcoated stents resulted in decreased vascular permeability relative to DES, which was further confirmed by SEM and TEM. Cell culture experiments examined the effect of everolimus on endothelial integrity. increasing concentrations of everolimus resulted in a dose-dependent decrease of endothelial cell junctions and foam cell transformation of monocytes, confirming the relevance of endothelial integrity in preventing permeability of LDL. Conclusion: Incomplete endothelial integrity was confirmed as a key factor of neointimal foam cell formation following stent implantation. pro-healing stent coatings may facilitate reendothelialization and reduce the risk of neoatherosclerosis.

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“…При этом капсула АСБ не визуализируется четко на всем протяжении, что может свидетельствовать о ее нестабильности и потенциальной клинической опасности. На возможную нестабильность АСБ также указывает ее эксцентрическая форма в отличие от концентрической формы гладкомышечной гиперплазии, наблюдаемой при развитии рестеноза в первый год после стентирования [9][10][11][12]. Тактика лечения пациента была выбрана следующая: учитывая наличие многососудистого поражения, высокий Syntax Score, было принято решение направить пациента на проведение операции аортокоронарного шунтирования.…”

Section: рис 1 ангиография субтотального стеноза до стентированияunclassified

Optical coherence tomography in differential diagnosis of the morphology of in-stent restenosis and neoaterosclerosis

Фомин

Руденко

Шаноян

et al. 2020

Cardiovasc Ther Prev

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Qualitative and quantitative neointimal characterization by optical coherence tomography in patients presenting with in-stent restenosis

Cited by 15 publications

References 25 publications

Clinical Outcomes of Drug-Eluting versus Bare-Metal In-Stent Restenosis after the Treatment of Drug-Eluting Stent or Drug-Eluting Balloon: A Systematic Review and Meta-Analysis

Clinical Outcomes of Drug-Eluting versus Bare-Metal In-Stent Restenosis after the Treatment of Drug-Eluting Stent or Drug-Eluting Balloon: A Systematic Review and Meta-Analysis

Assessment of a pro-healing stent in an animal model of early neoatherosclerosis

Optical coherence tomography in differential diagnosis of the morphology of in-stent restenosis and neoaterosclerosis

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