Qualitative and Quantitative Assessment of Stent Restenosis by Optical Coherence Tomography : – Comparison Between Drug-Eluting and Bare-Metal Stents –
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概要
- 論文の詳細を見る
Background: We hypothesized that the tissue components of in-stent restenosis (ISR) might differ between drug-eluting stents (DES) and bare-metal stents (BMS) and that these differences could be distinguished by qualitative and quantitative optical coherence tomography (OCT) analyses. Methods and Results: One-hundred and twenty-two initial ISR lesions (sirolimus-eluting stents: n=28; paclitaxel-eluting stents: n=51; BMS: n=43) were evaluated with OCT. Based on their OCT appearance, the lesions were classified as homogeneous, layered or heterogeneous. The optical properties of backscatter, attenuation and signal intensity of the neointimal tissue (NIT) were quantified. To evaluate the vascular response after balloon angioplasty (BA), the rate of reduction of the NIT area (NITA) was calculated (NITA before – after BA/NITA before BA at the minimum lumen cross-sectional area). Among the morphologic OCT patterns, the layered type was predominant with DES, whereas lesions were homogeneous with BMS (P<0.001). Backscatter and signal intensity were significantly higher with BMS (P<0.05 and P<0.001 respectively). The NITA reduction rate was significantly greater in the layered and heterogeneous groups than in the homogeneous group (P<0.01). Conclusions: The morphologic OCT patterns of the NIT in ISR differed significantly between DES and BMS, probably reflecting pathologic differences. Layered and heterogeneous tissues might respond better than homogeneous tissue to simple balloon dilatation, suggesting a possible direction for OCT-based ISR treatment strategies.
著者
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高谷 具史
兵庫県立姫路循環器病センター循環器科
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Inoue Takumi
Department of Cardiology, Himeji Cardiovascular Center
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Hayashi Takatoshi
Himeji cardiovascular center
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Yamada Shinichiro
Himeji cardiovascular center
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Takaya Tomofumi
Department of Cardiovascular Medicine, Saiseikai Nakatsu Hospital
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Kozuki Amane
Department of Cardiology, Kobe University
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Shinke Toshiro
Department of Cardiology, Kobe University
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Kawamori Hiroyuki
Department of Cardiology, Kobe University
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Otake Hiromasa
Department Of Cardiovascular Medicine Stanford University
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Hirata Ken-ichi
Department Cardiology Kobe University Graduate School Of Medicine
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Shite Junya
Department Of Cardiology Himeji Cardiovascular Center
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Nakagawa Masayuki
Department Of Anesthesiology Fukushima Medical University School Of Medicine
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Matsumoto Daisuke
Department Of Applied Biology Faculty Of Textile Science And Technology Shinshu University
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NISHIO Ryo
Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine
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NAGOSHI Ryoji
Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine
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HARIKI Hirotoshi
Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine
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TANIGUCHI Yu
Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine
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HIRANUMA Noritoshi
Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine
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KINUTANI Hiroto
Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine
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Konishi Akihide
Department Of Internal Medicine Division Of Cardiovascular Medicine Kobe University Graduate School Of Medicine
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Iwasaki Masamichi
Department Of Internal Medicine Division Of Cardiovascular Medicine Kobe University Graduate School Of Medicine
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Ohsue Tsuyoshi
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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Miyoshi Naoki
Himeji Cardiovascular Center
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Takaya Tomofumi
Himeji Cardiovascular Center
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Yasaka Yoshinori
Himeji Cardiovascular Center
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Yokoyama Mitsuhiro
Himeji Cardiovascular Center
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Kato Hiroki
Kakogawa East City Hospital
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Kadotani Makoto
Kakogawa East City Hospital
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Ohnishi Yoshio
Kakogawa East City Hospital
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Kawamori Hiroyuki
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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Hiranuma Noritoshi
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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高谷 具史
Department of Cardiovascular Medicine, Saiseikai Nakatsu Hospital
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Kinutani Hiroto
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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Nagoshi Ryoji
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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Hariki Hirotoshi
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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Hirata Ken-ichi
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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Taniguchi Yu
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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Shinke Toshiro
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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Nishio Ryo
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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Otake Hiromasa
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine
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