Abstract | OBJECTIVE: We sought to evaluate the characteristics of in- stent restenosis (ISR) lesions with microvessels, detected by an optical coherence tomography (OCT). BACKGROUND: No sufficient in vivo data exist regarding microvessel characteristics in ISR lesions. METHODS: Among 78 ISR lesions ( drug-eluting stent, n = 72; bare- metal stent, n = 6) in our OCT registry database, visible microvessels were detected in 21 (27%). Microvessels were defined as low backscattering structures <200 μm in diameter on OCT. Clinical, angiographic, and OCT findings were compared between lesions with and without microvessels. RESULTS: Lesions with microvessels had a larger reference vessel diameter (2.90 ± 0.47 mm vs 2.58 ± 0.42 mm; P=.009) and post- stent minimum lumen diameter (2.76 ± 0.29 mm vs 2.54 ± 0.39 mm; P=.033) than those without microvessels. From OCT findings at the segment with minimal lumen cross-sectional area (CSA), neointimal hyperplasia (NIH) CSA (5.4 ± 1.7 mm² vs 4.2 ± 2.1 mm²; P=.024) and percent NIH CSA (NIH CSA x 100/ stent CSA) were significantly greater in lesions with microvessels (79 ± 12% vs 67 ± 16%; P=.001). On multivariate analysis, reference vessel diameter (odds ratio [OR], 4.64; 95% confidence interval [CI], 1.05-20.4; P=.043) and percent NIH CSA at the segment with minimal lumen CSA (OR, 1.06; 95% CI, 1.01-1.12; P=.021) were independent predictors of microvessels. From receiver operating characteristic analysis, the cut-off values of reference vessel diameter and percent NIH CSA predicting the presence of microvessels were 3.1 mm and 74%, respectively. CONCLUSIONS: Visible microvessels in ISR lesions might be associated with increased vessel size and extent of NIH.
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Authors | Byeong-Keuk Kim, Jung-Sun Kim, Dong-Ho Shin, Young-Guk Ko, Donghoon Choi, Yangsoo Jang, Myeong-Ki Hong |
Journal | The Journal of invasive cardiology
(J Invasive Cardiol)
Vol. 24
Issue 3
Pg. 116-20
(Mar 2012)
ISSN: 1557-2501 [Electronic] United States |
PMID | 22388303
(Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Aged
- Angioplasty, Balloon, Coronary
- Coronary Restenosis
(pathology)
- Coronary Stenosis
(therapy)
- Coronary Vessels
(pathology)
- Drug-Eluting Stents
- Female
- Humans
- Logistic Models
- Male
- Microvessels
(pathology)
- Middle Aged
- Neointima
(pathology)
- ROC Curve
- Stents
- Tomography, Optical Coherence
(methods)
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