Effect of strut thickness on neointimal atherosclerotic change over an extended follow-up period (? years) after bare-metal stent implantation: Intracoronary optical coherence tomography examination

详细信息    查看全文

• 作者：Hironori Kitabata ; PhD ; ^{miu1205@hotmail.co.jp} ; Takashi Kubo ; PhD ; Kenichi Komukai ; MD ; Kohei Ishibashi ; MD ; Takashi Tanimoto ; PhD ; Yasushi Ino ; MD ; Shigeho Takarada ; PhD ; Yuichi Ozaki ; MD ; Manabu Kashiwagi ; MD ; Makoto Orii ; MD ; Masatsugu Shiono ; MD ; Kunihiro Shimamura ; MD ; Kumiko Hirata ; PhD ; Atsushi Tanaka ; PhD ; Keizo Kimura ; PhD ; Masato Mizukoshi ; PhD ; Toshio Imanishi ; PhD ; Takashi Akasaka ; PhD
• 刊名：American Heart Journal
• 出版年：2012
• 出版时间：April, 2012
• 年：2012
• 卷：163
• 期：4
• 页码：608-616
• 全文大小：1057 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Background

Neointima inside the bare-metal stents (BMSs) can transform into atherosclerotic tissue during an extended follow-up because of a persistent inflammatory reaction to the metal. We sought to investigate whether strut thickness may impact on the atherosclerotic change in neointima 4 years or more after BMS implantation using optical coherence tomography.

Methods

Forty-six stented lesions of 41 patients with BMS ? years after implantation who underwent optical coherence tomography were enrolled in the study. The strut was defined as thin when less than 100 ¦Ìm and thick when ?00 ¦Ìm. According to these criteria, stents were divided into 2 groups (thin strut n = 19, thick strut n = 27). Neointimal tissue was categorized into normal neointima, characterized by a signal-rich band without signal attenuation, or lipid-laden intima, with marked signal attenuation and a diffuse border. Intimal disruption, thrombus, and neovascularization were also evaluated.

Results

The mean period after implantation was 98.2 ¡À 25.8 months in the thin-strut group and 91.1 ¡À 22.8 months in the thick-strut group (P = .330). Lipid-laden intima (70 % vs 32 % , P = .016), thin-cap fibroatheroma-like intima (59 % vs 16 % , P = .0056), and intimal disruption (48 % vs 16 % , P = .031) were observed more frequently in the thick-strut group than in the thin-strut group, but no significant difference was observed in the frequency of thrombus. Although peristrut neovascularization was a common finding in both groups (thick vs thin 81 % vs 79 % , P = 1.000), the frequency of intraintima neovascularization tended to be higher in the thick-strut group (67 % vs 42 % , P = .135).

Conclusions

A thinner strut thickness may have favorable effects on neointimal atherosclerotic changes after BMS implantation.