Yonsei Med J.  2014 Jul;55(4):944-952. 10.3349/ymj.2014.55.4.944.

Optical Coherence Tomographic Observation of Morphological Features of Neointimal Tissue after Drug-Eluting Stent Implantation

• Lee SY
• Shin DH
• Kim JS
• Kim BK
• Ko YG
• Choi D
• Jang Y
• Hong MK

• KMID: 2130818
• DOI: http://doi.org/10.3349/ymj.2014.55.4.944

Abstract

PURPOSE
The impacts of different time courses and the degree of neointimal growth on neointimal morphology have not yet been sufficiently investigated. Therefore, we evaluated the morphological features of neointimal tissue after drug-eluting stent (DES) implantation using optical coherence tomography (OCT).
MATERIALS AND METHODS
The morphological features of neointimal tissue in stented segments with a maximal percentage of cross-sectional area (CSA) stenosis of neointima were evaluated in 507 DES-treated lesions with >100 microm mean neointimal thickness on follow-up OCT. Neointimal tissue was categorized as homogeneous, heterogeneous, layered, or neoatherosclerotic.
RESULTS
In lesions with <50% of neointimal CSA stenosis, homogeneous neointima (68.2%) was predominant, followed by heterogeneous neointima (14.1%) and layered neointima (14.1%). In lesions with > or =50% of neointimal CSA stenosis, layered neointima was most frequently observed (68.3%), followed by neoatherosclerotic neointima (25.2%). In subgroup analysis of lesions with > or =50% of neointimal CSA stenosis, 89.5% of the lesions with a stent age <30 months were layered neointima, while 62.3% of the lesions with a stent age > or =30 months were neoatherosclerotic neointima.
CONCLUSION
This study suggests that the OCT-detected morphology of DES neointimal tissue was different according to the follow-up time course and degree of neointimal hyperplasia.

Keyword

Optical coherence tomography; stent; coronary artery disease

MeSH Terms

Aged
Coronary Artery Disease/*surgery
*Drug-Eluting Stents
Female
Humans
Male
Middle Aged
Neointima/*diagnosis
Tomography, Optical Coherence/*methods

Figure

• 

  Fig. 1 Representative optical coherence tomographic images of neointimal tissue. (A) Homogeneous type. (B) Heterogeneous type. (C) Layered type. (D) Neoatherosclerotic type.

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  Fig. 2 Distribution of various neointimal tissues according to the percentage of neointimal cross-sectional area stenosis (A) and time interval of optical coherence tomography after index procedure (B).

• 

  Fig. 3 Distribution of various neointimal tissues according to the percentage of neointimal cross-sectional area stenosis in lesions of stent age <30 months (A) and ≥30 months (B).

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