TY - JOUR
T1 - Volumetric Intravascular Ultrasound Assessment of Neointimal Hyperplasia and Nonuniform Stent Strut Distribution in Sirolimus-Eluting Stent Restenosis
AU - Sano, Koichi
AU - Mintz, Gary S.
AU - Carlier, Stéphane G.
AU - Fujii, Kenichi
AU - Takebayashi, Hideo
AU - Kimura, Masashi
AU - Costa, Jose Ribamar
AU - Tanaka, Kaoru
AU - Costa, Ricardo A.
AU - Lui, Joanna
AU - Weisz, Giora
AU - Moussa, Issam
AU - Dangas, George D.
AU - Mehran, Roxana
AU - Lansky, Alexandra J.
AU - Kreps, Edward M.
AU - Collins, Michael
AU - Stone, Gregg W.
AU - Moses, Jeffrey W.
AU - Leon, Martin B.
PY - 2006/12/15
Y1 - 2006/12/15
N2 - The neointimal hyperplasia (IH) distribution pattern of in-stent restenotic lesions after sirolimus-eluting stent (SES) implantation has not been well described. We identified 48 in-stent restenotic lesions (41 patients) after SES implantation and performed volumetric intravascular ultrasound analyses. Lumen area, stent area, and IH area at the minimal lumen area site were 2.7 ± 1.0, 5.4 ± 1.9, and 2.7 ± 1.4 mm2, respectively. IH area at the minimal lumen site was larger in the group with a stent area ≥5.0 mm2 than the group with a stent area <5.0 mm2 (3.7 ± 1.3 vs 1.9 ± 0.8 mm2, p <0.001). There were fewer visualized stent struts in lesions with a minimum stent area ≥5.0 mm2 at the minimum lumen site compared with those with a stent area <5.0 mm2 (0.69 ± 0.25 vs 0.83 ± 0.16, p = 0.04). When we compared lesions in patients with diabetes mellitus with patients without diabetes, minimum lumen areas, percent IH at minimal lumen area, percent IH, and neointima-free stent length were identical. In conclusion, (1) lesions without SES underexpansion at the minimum lumen site had more IH and greater nonuniform stent strut distribution compared with restenotic SESs that were underexpanded, and (2) the IH response did not appear to be more aggressive in patients with diabetes mellitus than in those without diabetes mellitus.
AB - The neointimal hyperplasia (IH) distribution pattern of in-stent restenotic lesions after sirolimus-eluting stent (SES) implantation has not been well described. We identified 48 in-stent restenotic lesions (41 patients) after SES implantation and performed volumetric intravascular ultrasound analyses. Lumen area, stent area, and IH area at the minimal lumen area site were 2.7 ± 1.0, 5.4 ± 1.9, and 2.7 ± 1.4 mm2, respectively. IH area at the minimal lumen site was larger in the group with a stent area ≥5.0 mm2 than the group with a stent area <5.0 mm2 (3.7 ± 1.3 vs 1.9 ± 0.8 mm2, p <0.001). There were fewer visualized stent struts in lesions with a minimum stent area ≥5.0 mm2 at the minimum lumen site compared with those with a stent area <5.0 mm2 (0.69 ± 0.25 vs 0.83 ± 0.16, p = 0.04). When we compared lesions in patients with diabetes mellitus with patients without diabetes, minimum lumen areas, percent IH at minimal lumen area, percent IH, and neointima-free stent length were identical. In conclusion, (1) lesions without SES underexpansion at the minimum lumen site had more IH and greater nonuniform stent strut distribution compared with restenotic SESs that were underexpanded, and (2) the IH response did not appear to be more aggressive in patients with diabetes mellitus than in those without diabetes mellitus.
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U2 - 10.1016/j.amjcard.2006.07.030
DO - 10.1016/j.amjcard.2006.07.030
M3 - Article
C2 - 17145209
AN - SCOPUS:34347360228
SN - 0002-9149
VL - 98
SP - 1559
EP - 1562
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 12
ER -