Document Detail


Intravascular ultrasound, angioscopic and histopathological characterisation of heterogeneous patterns of restenosis after sirolimus-eluting stent implantation: insights into potential "thromborestenosis" phenomenon.
MedLine Citation:
PMID:  20884418     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIMS: Histopathology of DES restenosis remains unclear. The purpose is to examine restenotic tissue characteristics after sirolimus-eluting stent (SES) and comparing with that after bare-metal stent (BMS).
METHODS AND RESULTS: Intravascular ultrasound (IVUS), coronary angioscopy (CAS), and directional coronary atherectomy were performed simultaneously in 21 patients who presented restenosis after SES (n=13) and BMS (n=8). Mean time of restenosis was 10.8 months in the SES versus 7.5 months in the BMS. Typical "black hole'', echolucent appearance by IVUS was observed in one SES case, and corresponded to a fibrin rich tissue by histology which appeared translucent tissue by CAS. CAS did not reveal red thrombus, but showed white thrombus in six SES versus two BMS (46.2% vs. 25.0%, p=0.597). Histology demonstrated various patterns after SES including thrombus, fibrin, inflammatory infiltrate, and collagen-matrix rich tissue, while thrombus component was not detected in BMS. Thrombus and fibrin deposition detected by either CAS or histopathology were observed more frequently in SES than in BMS group (92.3% vs. 25.0%, p=0.007).
CONCLUSIONS: Restenosis after SES and BMS have different clinical and histological patterns. SES restenosis may be frequently associated with thrombus component.
Authors:
Yuji Oikawa; Junji Yajima; Marco A Costa; Shunsuke Matsuno; Masafumi Akabane; Ryuichi Funada; Toshiro Inaba; Yuya Nakagawa; Michinari Nakamura; Kazuyuki Nagashima; Hajime Kirigaya; Ken Ogasawara; Hitoshi Sawada; Tadanori Aizawa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  6     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-10-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  380-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, The Cardiovascular Institute Tokyo, Japan. oikawa@cvi.or.jp
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