Document Detail

Optical coherence tomography patterns of stent restenosis.
MedLine Citation:
PMID:  19619707     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Stent restenosis is an infrequent but poorly understood clinical problem in the drug-eluting stent era. The aim of the study was to evaluate the morphologic characteristics of stent restenosis by optical coherence tomography (OCT). METHODS: Patients (n = 24, 25 vessels) presenting with angiographically documented stent restenosis were included. Quantitative OCT analysis consisted of lumen and stent area measurement and calculation of restenotic tissue area and burden. Qualitative restenotic tissue analysis included assessment of tissue structure, backscattering and symmetry, visible microvessels, lumen shape, and presence of intraluminal material. RESULTS: By angiography, restenosis was classified as diffuse, focal, and at the margins in 9, 11, and 5 vessels, respectively. By OCT, restenotic tissue structure was layered in 52%, homogeneous in 28%, and heterogeneous in 20%. The predominant backscatter was high in 72%. Microvessels were visible in 12%. Lumen shape was irregular in 28% and there was intraluminal material in 20%. The mean restenotic tissue symmetry ratio was 0.58 +/- 0.19. Heterogeneous and low scattering restenotic tissue was more frequent in focal (45.5% and 54.5%, respectively) than in diffuse (0 and 11.1%) and margin restenosis (0 and 0%) (P = .005 for heterogeneous, P = .03 for low scattering). Restenosis patients with unstable angina symptoms presented more frequently irregular lumen shape (60 vs 6.7%, P = .007). Stents implanted </=12 months ago had more frequently restenotic tissue with layered appearance (84.6% vs 16.7%, P = .003). CONCLUSIONS: We demonstrate the ability of OCT to identify differential patterns of restenotic tissue after stenting. This information could help in understanding the mechanism of stent restenosis.
Nieves Gonzalo; Patrick W Serruys; Takayuki Okamura; Heleen M van Beusekom; Hector M Garcia-Garcia; Gijs van Soest; Wim van der Giessen; Evelyn Regar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  158     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-21     Completed Date:  2009-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  284-93     Citation Subset:  AIM; IM    
Thoraxcenter, Erasmus MC, Rotterdam 3015-CE, The Netherlands.
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MeSH Terms
Coronary Angiography
Coronary Restenosis / diagnosis*,  pathology
Drug-Eluting Stents
Middle Aged
Tomography, Optical Coherence*

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