In-stent restenosis assessed with frequency domain optical coherence tomography shows smooth coronary arterial healing process in second-generation drug-eluting stents

Abstract

Homogeneous tissue morphology was more frequently found for second-generation DES ISR than first-generation DES ISR, especially in the late phase. This finding suggested that neointimal hyperplasia was the main mechanism in second-generation DES ISR and the neointima was stabilised much like after bare metal stent implantation.

Optical Coherence Tomography Findings in Patients Presenting With In-Stent Restenosis: A Prospective Observational Study of Patterns of Neointimal Hyperplasia and Associated Risk Factors

“…This observation is suggestive of differential prognosis of stented lesions according to in-stent neointimal characteristics [9]. Although previous studies have explored correlations between neointimal patterns, underlying stent type, and restenosis phase, the degree of intralesional neointimal characteristics has not been elucidated [5,10,11]. Therefore, this study sought to qualitatively and quantitatively assess neointimal characteristics of lesions using OCT in patients presenting with ISR.…”

“…The bare-metal stent era witnessed a 32-55% incidence of ISR whereas the introduction of second-generation drug-eluting stents prompted a decline in ISR incidence to 10-12.2% [2][3][4]. Nonetheless, ISR still prevails to a lesser extent in routine clinical practice [5]. Intracoronary optical coherence tomography (OCT) provides a higher axial resolution than conventional intravascular ultrasound.…”