scholarly journals The Impact of In-stent Restenosis Detected upon Routine Follow-up Angiography after Percutaneous Coronary Intervention with Metallic Stent

2018 ◽  
Vol 9 (2) ◽  
pp. 53-62
Author(s):  
Nozomi Kotoku ◽  
Yuki Ishibashi ◽  
Takumi Higuma ◽  
Kihei Yoneyama ◽  
Hiroshi Yamazaki ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Metallic Stent ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
The Impact ◽  
In Stent Restenosis

P5614The association between tissue morphology assessed with optical coherence tomography and mid and late-term results after percutaneous coronary intervention for in-stent restenosis lesions

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Tada ◽  
K Miura ◽  
M Ohya ◽  
T Shimada ◽  
R Murai ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Midterm Results ◽  
Fibrous Plaque ◽  
Tissue Morphology ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
In Stent Restenosis

Abstract Background It was reported that tissue morphology of in-stent restenosis (ISR) lesions assessed with optical coherence tomography (OCT) had an effect on midterm results including ISR and target lesion revascularization (TLR) rates after percutaneous coronary intervention (PCI). However, little was known about the association between tissue morphology assessed with OCT and late-term results. Methods We performed PCI treated with paclitaxel coated balloon (PCB) or drug-eluting stent (DES) for 452 ISR lesions (260 lesions with fibrous plaque and 192 lesions with lipid-laden plaque) using OCT between May 2008 and July 2016. Six- to eight-month (midterm) angiographic follow-up was performed on 422 of the 452 ISR lesions (follow-up rate: 93.4%). Furthermore, eighteen- to twenty-month (late-term) angiographic follow-up was performed on 337 of the 361 ISR lesions (follow-up rate: 93.4%) which were free from midterm TLR. We examined the association between tissue morphology, midterm-results and late-term results including ISR and TLR rates. Fibrous plaque was defined as homogeneous, signal-rich regions with low attenuation. Lipid-laden plaque was defined as diffuse border, signal poor regions with high attenuation. Results The patients were 353 men and 69 women, and the mean age was 68.8±9.6 years. PCI were performed with PCB in 285 lesions (PCB group) and DES in 137 lesions (DES group). The figure shows the angiographic midterm results of the 422 lesions and late-term results of the 337 lesions with respect to each tissue morphology and each PCI device. There was no difference in ISR and TLR rates of lesions with both fibrous and lipid-laden plaque at midterm between the two groups. ISR and TLR rates of lesions with lipid-laden plaque at late-term were significantly higher in the PCB group than in the DES group, while there was no difference in ISR and TLR rates of lesions with fibrous plaque at late-term between two groups. Figure 1 Conclusion Tissue morphology of ISR lesions might have an impact on outcomes after PCI. Morphological assessment of ISR tissue using OCT might suggest favorable types of PCI for ISR lesions.

In vivo and in vitro analyses of the effects of a novel high-nitrogen low-nickel coronary stent on reducing in-stent restenosis

2018 ◽  
Vol 33 (1) ◽  
pp. 64-71 ◽  
Author(s):  
Jinpeng Wang ◽  
Chunli Song ◽  
Yanlong Xiao ◽  
Bin Liu
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Arteries ◽  
Coronary Intervention ◽  
Coronary Stent ◽  
High Nitrogen ◽  
Stent Restenosis ◽  
Percutaneous Coronary ◽  
In Stent Restenosis

Currently, percutaneous coronary intervention is an important treatment for coronary heart disease. However, the in-stent restenosis rate is still approximately 10–30% after stenting. Nickel ions from the stent are considered to be associated with in-stent restenosis. Therefore, in the present study, we quantitatively evaluated in-stent restenosis after implanting the novel high-nitrogen low-nickel coronary stent (HNS) and studied the mechanism underlying the reduction in in-stent restenosis by using ELISA and Western blot. The in vivo results showed that the HNS could significantly reduce neointima formation and inflammation as compared to SUS316L stents (316L) at 180 days after implantation in porcine coronary arteries and that vascular endothelial growth factor-A expression in porcine coronary arteries after HNS implantation also decreased. The in vitro results showed that, in the case of the HNS, human umbilical vein endothelial cell (HUVEC) proliferation was lower and lesser IL-6 release was noted from HUVECs at one and three days after culture than in the 316L group. Furthermore, p-STAT3 expression in HUVECs on the HNS surface was downregulated after culture for seven days. Thus, we conclude that the HNS could be a promising alternative coronary stent for percutaneous coronary intervention.

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