Document Detail


In vivo virtual histology intravascular ultrasound comparison of neointimal hyperplasia within drug-eluting- versus bare metal stents.
MedLine Citation:
PMID:  21725119     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The process of in-stent neointimal hyperplasia (NIH) between drug-eluting stents (DES) and bare metal stents (BMS) might be different. We compared in vivo composition of in-stent NIH between DES and BMS using virtual histology-intravascular ultrasound (VH-IVUS).
METHODS AND RESULTS: Volumetric VH-IVUS was used to compare in-stent NIH between 23 DES and 15 BMS in 30 patients who underwent coronary angiography because of angina. The inner and outer VH-IVUS contours were drawn in a way to avoid the stent strut artifacts. Cross-sectional analysis was done at every VH-IVUS frame within the stent, thereby allowing volumetric measurement of stent, lumen, and NIH and its components. Baseline characteristics and IVUS measurements were similar between DES and BMS groups. The duration of follow-up was similar between DES (median 38 months [interquartile range, 7-59]) vs. BMS (median 40 months [interquartile range, 7-99]), (p=0.26). % necrotic core (NC) volume was significantly higher in DES than BMS: 19.5 [16.3, 25.6] vs. 12.1 [8.2, 18.5] (p=0.006). %NC volume significantly increased with time in BMS (p=0.007), but not in DES (p=0.24) so that at any given time point, %NC in DES was greater than in BMS. After adjustment for baseline differences, only DES (p=0.003) and stent age (p=0.043) were independent predictors of %NC volume. VH-IVUS in-stent thin-cap fibroatheromas were detected only in the DES group: 34.8% vs. 0%, p=0.013.
CONCLUSION: In vivo composition of in-stent NIH between DES and BMS was different, suggesting that the process of in-stent NIH in DES and BMS is diverse.
Authors:
Kohei Wakabayashi; Gary Mintz; Cedric Delhaye; Yu Jeong Choi; Joon Hyung Doh; Itsik Ben-Dor; Michele Gaglia; Rajbabu Pakala; William Suddath; Lowell Satler; Kenneth Kent; Augusto Pichard; Neil Weissman; Ron Waksman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  23     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-07-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  262-8     Citation Subset:  IM    
Affiliation:
Washington Hospital Center, Division of Cardiology, 110 Irving St., NW, Suite 4B-1, Washington, DC 20010 USA. ron.waksman@medstar.net.
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