Volumetric Intravascular Ultrasound Assessment of Neointimal Hyperplasia and Nonuniform Stent Strut Distribution in Sirolimus-Eluting Stent Restenosis

Koichi Sano, Gary S. Mintz, Stéphane G. Carlier, Kenichi Fujii, Hideo Takebayashi, Masashi Kimura, Jose Ribamar Costa, Kaoru Tanaka, Ricardo A. Costa, Joanna Lui, Giora Weisz, Issam Moussa, George D. Dangas, Roxana Mehran, Alexandra J. Lansky, Edward M. Kreps, Michael Collins, Gregg W. Stone, Jeffrey W. Moses, Martin B. Leon

Research output: Contribution to journalArticle

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Abstract

The neointimal hyperplasia (IH) distribution pattern of in-stent restenotic lesions after sirolimus-eluting stent (SES) implantation has not been well described. We identified 48 in-stent restenotic lesions (41 patients) after SES implantation and performed volumetric intravascular ultrasound analyses. Lumen area, stent area, and IH area at the minimal lumen area site were 2.7 ± 1.0, 5.4 ± 1.9, and 2.7 ± 1.4 mm2, respectively. IH area at the minimal lumen site was larger in the group with a stent area ≥5.0 mm2 than the group with a stent area <5.0 mm2 (3.7 ± 1.3 vs 1.9 ± 0.8 mm2, p <0.001). There were fewer visualized stent struts in lesions with a minimum stent area ≥5.0 mm2 at the minimum lumen site compared with those with a stent area <5.0 mm2 (0.69 ± 0.25 vs 0.83 ± 0.16, p = 0.04). When we compared lesions in patients with diabetes mellitus with patients without diabetes, minimum lumen areas, percent IH at minimal lumen area, percent IH, and neointima-free stent length were identical. In conclusion, (1) lesions without SES underexpansion at the minimum lumen site had more IH and greater nonuniform stent strut distribution compared with restenotic SESs that were underexpanded, and (2) the IH response did not appear to be more aggressive in patients with diabetes mellitus than in those without diabetes mellitus.

Original languageEnglish (US)
Pages (from-to)1559-1562
Number of pages4
JournalAmerican Journal of Cardiology
Volume98
Issue number12
DOIs
StatePublished - Dec 15 2006

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Sirolimus
Hyperplasia
Stents
Diabetes Mellitus
Neointima

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Sano, Koichi ; Mintz, Gary S. ; Carlier, Stéphane G. ; Fujii, Kenichi ; Takebayashi, Hideo ; Kimura, Masashi ; Costa, Jose Ribamar ; Tanaka, Kaoru ; Costa, Ricardo A. ; Lui, Joanna ; Weisz, Giora ; Moussa, Issam ; Dangas, George D. ; Mehran, Roxana ; Lansky, Alexandra J. ; Kreps, Edward M. ; Collins, Michael ; Stone, Gregg W. ; Moses, Jeffrey W. ; Leon, Martin B. / Volumetric Intravascular Ultrasound Assessment of Neointimal Hyperplasia and Nonuniform Stent Strut Distribution in Sirolimus-Eluting Stent Restenosis. In: American Journal of Cardiology. 2006 ; Vol. 98, No. 12. pp. 1559-1562.
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title = "Volumetric Intravascular Ultrasound Assessment of Neointimal Hyperplasia and Nonuniform Stent Strut Distribution in Sirolimus-Eluting Stent Restenosis",
abstract = "The neointimal hyperplasia (IH) distribution pattern of in-stent restenotic lesions after sirolimus-eluting stent (SES) implantation has not been well described. We identified 48 in-stent restenotic lesions (41 patients) after SES implantation and performed volumetric intravascular ultrasound analyses. Lumen area, stent area, and IH area at the minimal lumen area site were 2.7 ± 1.0, 5.4 ± 1.9, and 2.7 ± 1.4 mm2, respectively. IH area at the minimal lumen site was larger in the group with a stent area ≥5.0 mm2 than the group with a stent area <5.0 mm2 (3.7 ± 1.3 vs 1.9 ± 0.8 mm2, p <0.001). There were fewer visualized stent struts in lesions with a minimum stent area ≥5.0 mm2 at the minimum lumen site compared with those with a stent area <5.0 mm2 (0.69 ± 0.25 vs 0.83 ± 0.16, p = 0.04). When we compared lesions in patients with diabetes mellitus with patients without diabetes, minimum lumen areas, percent IH at minimal lumen area, percent IH, and neointima-free stent length were identical. In conclusion, (1) lesions without SES underexpansion at the minimum lumen site had more IH and greater nonuniform stent strut distribution compared with restenotic SESs that were underexpanded, and (2) the IH response did not appear to be more aggressive in patients with diabetes mellitus than in those without diabetes mellitus.",
author = "Koichi Sano and Mintz, {Gary S.} and Carlier, {St{\'e}phane G.} and Kenichi Fujii and Hideo Takebayashi and Masashi Kimura and Costa, {Jose Ribamar} and Kaoru Tanaka and Costa, {Ricardo A.} and Joanna Lui and Giora Weisz and Issam Moussa and Dangas, {George D.} and Roxana Mehran and Lansky, {Alexandra J.} and Kreps, {Edward M.} and Michael Collins and Stone, {Gregg W.} and Moses, {Jeffrey W.} and Leon, {Martin B.}",
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Sano, K, Mintz, GS, Carlier, SG, Fujii, K, Takebayashi, H, Kimura, M, Costa, JR, Tanaka, K, Costa, RA, Lui, J, Weisz, G, Moussa, I, Dangas, GD, Mehran, R, Lansky, AJ, Kreps, EM, Collins, M, Stone, GW, Moses, JW & Leon, MB 2006, 'Volumetric Intravascular Ultrasound Assessment of Neointimal Hyperplasia and Nonuniform Stent Strut Distribution in Sirolimus-Eluting Stent Restenosis', American Journal of Cardiology, vol. 98, no. 12, pp. 1559-1562. https://doi.org/10.1016/j.amjcard.2006.07.030

Volumetric Intravascular Ultrasound Assessment of Neointimal Hyperplasia and Nonuniform Stent Strut Distribution in Sirolimus-Eluting Stent Restenosis. / Sano, Koichi; Mintz, Gary S.; Carlier, Stéphane G.; Fujii, Kenichi; Takebayashi, Hideo; Kimura, Masashi; Costa, Jose Ribamar; Tanaka, Kaoru; Costa, Ricardo A.; Lui, Joanna; Weisz, Giora; Moussa, Issam; Dangas, George D.; Mehran, Roxana; Lansky, Alexandra J.; Kreps, Edward M.; Collins, Michael; Stone, Gregg W.; Moses, Jeffrey W.; Leon, Martin B.

In: American Journal of Cardiology, Vol. 98, No. 12, 15.12.2006, p. 1559-1562.

Research output: Contribution to journalArticle

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T1 - Volumetric Intravascular Ultrasound Assessment of Neointimal Hyperplasia and Nonuniform Stent Strut Distribution in Sirolimus-Eluting Stent Restenosis

AU - Sano, Koichi

AU - Mintz, Gary S.

AU - Carlier, Stéphane G.

AU - Fujii, Kenichi

AU - Takebayashi, Hideo

AU - Kimura, Masashi

AU - Costa, Jose Ribamar

AU - Tanaka, Kaoru

AU - Costa, Ricardo A.

AU - Lui, Joanna

AU - Weisz, Giora

AU - Moussa, Issam

AU - Dangas, George D.

AU - Mehran, Roxana

AU - Lansky, Alexandra J.

AU - Kreps, Edward M.

AU - Collins, Michael

AU - Stone, Gregg W.

AU - Moses, Jeffrey W.

AU - Leon, Martin B.

PY - 2006/12/15

Y1 - 2006/12/15

N2 - The neointimal hyperplasia (IH) distribution pattern of in-stent restenotic lesions after sirolimus-eluting stent (SES) implantation has not been well described. We identified 48 in-stent restenotic lesions (41 patients) after SES implantation and performed volumetric intravascular ultrasound analyses. Lumen area, stent area, and IH area at the minimal lumen area site were 2.7 ± 1.0, 5.4 ± 1.9, and 2.7 ± 1.4 mm2, respectively. IH area at the minimal lumen site was larger in the group with a stent area ≥5.0 mm2 than the group with a stent area <5.0 mm2 (3.7 ± 1.3 vs 1.9 ± 0.8 mm2, p <0.001). There were fewer visualized stent struts in lesions with a minimum stent area ≥5.0 mm2 at the minimum lumen site compared with those with a stent area <5.0 mm2 (0.69 ± 0.25 vs 0.83 ± 0.16, p = 0.04). When we compared lesions in patients with diabetes mellitus with patients without diabetes, minimum lumen areas, percent IH at minimal lumen area, percent IH, and neointima-free stent length were identical. In conclusion, (1) lesions without SES underexpansion at the minimum lumen site had more IH and greater nonuniform stent strut distribution compared with restenotic SESs that were underexpanded, and (2) the IH response did not appear to be more aggressive in patients with diabetes mellitus than in those without diabetes mellitus.

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