Neoatherosclerosis and Mural Thrombus Detection After Sirolimus-Eluting Stent Implantation:– Comparison of Angioscopy and Optical Coherence Tomography Assessment for Color-Based Tissue Characterization –
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概要
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Background: Although both optical coherence tomography (OCT) and angioscopy are robust tools for detecting intrastent thrombi and neoatherosclerosis in vivo, whether OCT findings are comparable with angioscopy findings remains unclear. Methods and Results: 22 patients presenting with de novo lesions underwent 26 sirolimus-eluting stent (SES) implantations, with follow-up OCT and angioscopy at 10 months post-implantation for segmental assessment of the proximal, mid-, and distal SES segments (66 segments). The mean signal intensity index (signal intensity of the neointima/signal intensity of fibrous intimal hyperplasia) was quantified for angioscopically detected in-stent yellow and white segments. The detection rate for red thrombi was numerically higher with angioscopy than with OCT (17% vs. 9%; P=0.053). Angioscopically detected in-stent yellow segments were categorized into 3 OCT patterns: "high-attenuation tissue covering struts" (OCT-defined neoatherosclerosis), "high-attenuation tissue underneath struts," and "low-attenuation and low-intensity tissue covering struts"; further, macrophage-like appearance was most frequently observed with OCT-defined neoatherosclerosis (56%, 6.3%, and 0%, respectively, P<0.001). The mean signal intensity index of neoatherosclerosis was significantly lower than that of angioscopically detected in-stent white segments (0.929 vs. 0.997, P=0.004). Conclusions: Current OCT-based definitions for thrombus detection may underestimate the presence of subclinical red thrombi. Qualitative and quantitative OCT assessments of the neointima may enhance the detection of neoatherosclerosis over SES in vivo.
- 一般社団法人 日本循環器学会の論文
著者
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Inoue Takumi
Division of Cardiology, Hjimeji Cardiovascular Center
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Shinke Toshiro
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University
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Taniguchi Yu
Division of Cardiology, Heart Institute, Chiba-Nishi General Hospital
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Hirata Ken-ichi
Division Of Cardiovascular Medicine Department Of Internal Medicine Kobe University Graduate School
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Hariki Hirotoshi
Division Of Cardiovascular Medicine Department Of Internal Medicine Kobe University Graduate School
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Nakagawa Masayuki
Division Of Cardiovascular Medicine Department Of Internal Medicine Kobe University Graduate School
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Otake Hiromasa
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Kinutani Hiroto
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Nishio Ryo
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Hiranuma Noritoshi
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Shite Junya
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Osue Tsuyoshi
Division Of Cardiovascular And Respiratory Medicine Department Of Internal Medicine Kobe University Graduate School Of Medicine
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Konishi Akihide
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Iwasaki Masamichi
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Hariki Hirotoshi
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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HIRATA Ken-ichi
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Konishi Akihide
Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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