Neointima and neoatherosclerotic characteristics in bare metal and first- and second-generation drug-eluting stents in patients admitted with cardiovascular events attributed to stent failure: an optical coherence tomography study.

Stettler, Rodrigue; Dijkstra, Jouke; Räber, Lorenz; Torii, Ryo; Zhang, Yao-Jun; Karanasos, Antonios; Lui, Shengnan; Crake, Tom; Hamshere, Steve; Garcia-Garcia, Hector M; Tenekecioglu, Erhan; Ozkor, Muhiddin; Windecker, Stephan; Serruys, Patrick W; Regar, Evelyn; Mathur, Anthony; Bourantas, Christos V (2018). Neointima and neoatherosclerotic characteristics in bare metal and first- and second-generation drug-eluting stents in patients admitted with cardiovascular events attributed to stent failure: an optical coherence tomography study. EuroIntervention, 13(15), e1831-e1840. Europa Digital & Publishing 10.4244/EIJ-D-17-00051

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AIMS The aim of this study was to assess neoatherosclerotic plaque morphology in bare metal (BMS) and first- and second-generation drug-eluting stents (DES) in patients presenting with an event attributed to stent failure. METHODS AND RESULTS Thirty-five patients (11 implanted with BMS, 13 with a first-generation and 11 with a second-generation DES) admitted with an event due to stent failure who had neoatherosclerotic lesions on optical coherence tomography were included in the analysis. The lumen and stent borders were detected and the lipid and calcific tissue were identified in the neointima and their burden was estimated. The neointima attenuation and backscatter indices were computed and compared between the different stent types. Although there were no differences in the neointima burden, the BMS group exhibited thinner fibrous caps (p<0.001), and a numerically increased incidence of lipid-rich plaques (p=0.052) and macrophage accumulation (p=0.012). Neointima discontinuities (p=0.009) and thrombus (p=0.032) were seen more often in first-generation DES. In all stent types, neoatherosclerosis had focal manifestations. In neoatherosclerotic lesions the attenuation and backscatter indices were increased in BMS (p=0.031 and p=0.018, respectively) compared to DES; however, there were no differences between stents in the attenuation indices in subsegments located distally to neoatherosclerotic lesions which had low values in all stent types. CONCLUSIONS Although there are differences in lipid burden and neointima characteristics in different stent types, in all stents neoatherosclerosis has focal manifestations indicating that, irrespective of the stent type, focal triggers are involved in the generation of vulnerable neolesions.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Räber, Lorenz and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1774-024X

Publisher:

Europa Digital & Publishing

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

12 Apr 2018 10:49

Last Modified:

28 Oct 2019 13:26

Publisher DOI:

10.4244/EIJ-D-17-00051

PubMed ID:

28606888

BORIS DOI:

10.7892/boris.111090

URI:

https://boris.unibe.ch/id/eprint/111090

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