MedStar Authors catalog › Details for: Intra-stent tissue evaluation within bare metal and drug-eluting stents > 3 years since implantation in patients with mild to moderate neointimal proliferation using optical coherence tomography and virtual histology intravascular ultrasound.
Intra-stent tissue evaluation within bare metal and drug-eluting stents > 3 years since implantation in patients with mild to moderate neointimal proliferation using optical coherence tomography and virtual histology intravascular ultrasound. Journal: Cardiovascular revascularization medicine : including molecular interventions. ISSN: 1878-0938. UI/PMID: 24767313. Subject(s): Aged | *Cell Proliferation | Coronary Artery Disease/pa [Pathology] | *Coronary Artery Disease/th [Therapy] | Coronary Artery Disease/us [Ultrasonography] | *Coronary Vessels/pa [Pathology] | *Coronary Vessels/us [Ultrasonography] | *Drug-Eluting Stents | Female | Humans | Male | *Metals | Middle Aged | *Neointima | Percutaneous Coronary Intervention/ae [Adverse Effects] | *Percutaneous Coronary Intervention/is [Instrumentation] | Predictive Value of Tests | Prospective Studies | Prosthesis Design | Severity of Illness Index | *Stents | Time Factors | *Tomography, Optical Coherence | Treatment Outcome | *Ultrasonography, Interventional Institution(s): MedStar Heart & Vascular Institute Activity type: Journal Article. Medline article type(s): Comparative Study | Journal Article | Observational Study Digital Object Identifier: http://dx.doi.org/10.1016/j.carrev.2014.01.009 (Click here) Abbreviated citation: Cardiovasc Revasc Med. 15(3):149-55, 2014 Apr. Local Holdings: Available in print through MWHC library: 2002 - present. Abstract: OBJECTIVE: We aimed to compare neointimal tissue characteristics between bare-metal stents (BMS) and drug-eluting stents (DES) at long-term follow-up using optical coherence tomography (OCT) and virtual histology intravascular ultrasound (VH-IVUS). Abstract: BACKGROUND: Neoatherosclerosis in neointima has been reported in BMS and in DES. Abstract: METHODS: Thirty patients with 36 stented lesions [BMS (n=17) or DES (n=19)] >3years after implantation were prospectively enrolled. OCT and VH-IVUS were performed and analyzed independently. Stents with >70% diameter stenosis were excluded. Abstract: RESULTS: The median duration from implantation was 126.0months in the BMS group and 60.0months in the DES group (p <0.001). Lipid-laden intima (58.8% vs. 42.1%, p=0.317), thrombus (17.6% vs. 5.3%, p=0.326), and calcification (35.3% vs. 26.3%, p=0.559) did not show significant differences between BMS and DES. When divided into 3 time periods, the cumulative incidence of lipid-laden neointima from >3years to <9years was similar between BMS and DES (42.9% vs. 42.1%, p=1.000). Furthermore, it continued to gradually increase over time in both groups. OCT-derived thin-cap fibroatheroma (TCFA) was observed in 17.6% of BMS- and 5.3% of DES-treated lesions (p=0.326). No stents had evidence of intimal disruption. The percentage volume of necrotic core (16.1% [9.7, 20.3] vs. 9.7% [7.0, 16.5], p=0.062) and dense calcium (9.5% [3.8, 13.6] vs. 2.7% [0.4, 4.9], p=0.080) in neointima tended to be greater in BMS-treated lesions. Intra-stent VH-TCFA (BMS vs. DES 45.5% vs. 18.2%, p=0.361) did not differ significantly.
Abstract: CONCLUSION: At long-term follow-up beyond 3 years after implantation, the intra-stent neointimal tissue characteristics appeared similar for both BMS and DES.Copyright � 2014 Elsevier Inc. All rights reserved.