Neointimal patterns obtained by optical coherence tomography correlate with specific histological components and neointimal proliferation in a swine model of restenosis

Kim, Jung Sun; Afari, Maxwell Eyram; Ha, Job; Téllez, Armando; Milewski, Krzysztof; Conditt, Gerard; Cheng, Yanping; Geng, Ying; Kałuża, Greg L.; Granada, Juan F.

doi:10.1093/ehjci/jet162

Cited by 55 publications

(48 citation statements)

References 23 publications

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“…In addition, recent studies suggest that the different characteristics of neointimal tissue seen by OCT may correlate with clinical events such as late stent thrombosis. 20) Kim, et al 21) compared different OCT morphological characteristics with different in-stent neointimal tissue types analyzed by histology and found that the homogeneous pattern of neointimal formation appeared to correlate with less neointimal formation and more favorable vessel healing characteristics when compared with the other optical patterns; the heterogeneous pattern correlated more with the presence of fibrin deposits than the other patterns; the layered pattern correlated with the higher incidence of peri-strut inflammation, neovascularization, and external elastic lamina rupture, which might lead to a higher degree of neointimal proliferation. In a clinical study, Tanaka, et al 22) concluded that in DM patients, the heterogeneous pattern was observed with high frequency.…”

Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Assessment of Glucose Fluctuation Impact on the Neointimal Proliferation After Stent Implantation in a Diabetic/Hypercholesterolemic Swine Model

Xia

Yin

et al. 2017

Int. Heart J.

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SummaryThe aim of the present study was to investigate the effects of glucose fluctuation on neointimal proliferation after stent implantation by optical coherence tomography (OCT) in a diabetic/hypercholesterolemic (DM/HC) swine model.A total of 24 everolimus-eluting stents (EES) were implanted in the right coronary artery (RCA) of the animals using a 20% overstretch ratio. The 24 swines were divided into a DM-high glucose fluctuation (HGF) group (n = 8), DMlow glucose fluctuation (LGF) group (n = 8), and a control group (n = 8). Percent diameter stenosis (%DS), late loss (LL), percent area stenosis (%AS), and neointimal thickness (NIT) were analyzed. The differences in neointimal characteristics and circulating oxidative stress and inflammation biomarkers were assessed and measured.At 28 days, the highest values of %DS, LL, %AS, and NIT were achieved in the HGF group followed by the LGF group (P < 0.05) and the control group (P < 0.05). The highest frequency of the heterogeneous pattern was in the HGF group followed by the LGF group (P < 0.05) and the control group (P < 0.05). This was also the case for the oxidative stress and inflammation biomarkers.DM might have a deleterious impact on neointimal proliferation after EES implantation in this DM/HC swine model. The extent of glucose fluctuation may be related to the degree of neointimal proliferation and this needs to be further confirmed by long-term follow-up and histology. (Int Heart J 2017; 58: 608-614) Key words: Glucose variability, Diabetes mellitus, Intravascular imaging, Intima A n extensive amount of research has focused on how to improve outcomes after drug eluting stent (DES) implantation. Dyslipidemia and high blood pressure have been recognized as the most important promoters of stent restenosis. A large number of clinical trials have reported the beneficial effects of lipid lowering and blood pressure lowering for secondary prevention and improved all-cause mortality. However, the limited ability of risk reduction associated with lipid-lowering and blood pressure lowering therapy has attracted attention to the unmet need for residual clinical risk management.Diabetes mellitus (DM) in the form of chronic sustained hyperglycemia is thought to be associated with worse outcome after DES implantation. There is increasing evidence that glucose fluctuation produces more detrimental effects on the coronary arteries than chronic sustained hyperglycemia. Epidemiological studies have suggested that glucose fluctuation may be a marker of increased progression of coronary disease. However, it remains unclear whether glucose fluctuations may affect vessel healing after EES implantation and the detailed impact of glucose fluctuation on neointimal proliferation remains elusive. The related preclinical data is lacking.Optical coherence tomography (OCT) is emerging as a very important imaging device for the evaluation of coronary plaque characteristics and neointimal proliferation after stenting due to its high-resolution.1,2) The human-like porcine model of DM/...

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Section: Discussionmentioning

confidence: 99%

Optical Coherence Tomography Assessment of Glucose Fluctuation Impact on the Neointimal Proliferation After Stent Implantation in a Diabetic/Hypercholesterolemic Swine Model

Xia

Yin

et al. 2017

Int. Heart J.

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“…Later, the extracellular matrix increases and the number of smooth muscle cells decreases [14]. This condition develops into neointimal hyperplasia, which eventually causes ISR [15].…”

Section: Discussionmentioning

confidence: 99%

Role of red blood cell distribution in predicting drug-eluting stent restenosis in patients with stable angina pectoris after coronary stenting

Zhao

Gao

2015

Coronary Artery Disease

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“…The length of an arc of lipid and calcium that occupied the vessel wall circumference was measured and expressed in degrees. 16, 17 The maximum lipid arc and calcium arc were measured. The thickness of the fibrous cap that covered the lipid core was measured in the thinnest part of a signal-rich zone that separated the lipid content from the vessel lumen (µm).…”

Section: Oct Analysismentioning

confidence: 99%

Optical Coherence Tomography of De Novo Lesions and In-Stent Restenosis in Coronary Saphenous Vein Grafts (OCTOPUS Study)

Roleder

Pociask

Wańha

et al. 2016

Circ J

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Background:The OCTOPUS registry prospectively evaluates the procedural and long-term outcomes of saphenous vein graft (SVG) PCI. The current study assessed the morphology of de novo lesions and in-stent restenosis (ISR) in patients undergoing PCI of SVG. Methods and Results:Optical coherence tomography (OCT) of SVG lesions in consecutive patients presenting with stable CAD and ACS was carried out. Thirty-nine patients (32 de novo and 10 ISR lesions) were included in the registry. ISR occurred in 5 BMS and 5 DES. There were no differences in the presence of plaque rupture and thrombus between de novo lesions and ISR. Lipid-rich tissue was identified in both de novo lesions and in ISR (75% vs. 50%, P=0.071) with a higher prevalence in BMS than in DES (23% vs. 7.5%; P=0.048). Calcific de novo lesions were detected in older grafts as compared with non-calcific atheromas (159±57 vs. 90±62 months after CABG, P=0.001). Heterogeneous neointima was found only in ISR (70% vs. 0, P<0.001) and was observed with similar frequency in both BMS and DES (24% vs. 30%, P=0.657). ISR was detected earlier in DES than BMS (median, 50 months; IQR, 18-96 months vs. 27 months; IQR, 13-29 months, P<0.001). Conclusions:OCT-based characteristics of de novo and ISR lesions in SVG were similar except for heterogeneous tissue, which was observed only in ISR. (Circ J 2016; 80: 1804 -1811

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Neointimal patterns obtained by optical coherence tomography correlate with specific histological components and neointimal proliferation in a swine model of restenosis

Abstract: The optical characteristics of neointimal formation seen in OCT properly correlated with the presence of several histological findings involved in stent healing. The biological implications of these findings in clinical outcomes require further investigation.

Cited by 55 publications

References 23 publications

Optical Coherence Tomography Assessment of Glucose Fluctuation Impact on the Neointimal Proliferation After Stent Implantation in a Diabetic/Hypercholesterolemic Swine Model

Optical Coherence Tomography Assessment of Glucose Fluctuation Impact on the Neointimal Proliferation After Stent Implantation in a Diabetic/Hypercholesterolemic Swine Model

Role of red blood cell distribution in predicting drug-eluting stent restenosis in patients with stable angina pectoris after coronary stenting

Optical Coherence Tomography of De Novo Lesions and In-Stent Restenosis in Coronary Saphenous Vein Grafts (OCTOPUS Study)

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