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The clinical characteristics and prognosis of lesions with in-stent eccentric tissue proliferation and strong signal attenuation detected by optical coherence tomography

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Abstract

There are still some patients who require repeat revascularization despite of drug-eluting stent (DES) implantation. The present study aimed to investigate the relationship between optical coherence tomography (OCT) findings and recurring target lesion revascularization (TLR) after percutaneous coronary intervention (PCI) for in-stent restenosis (ISR). We reviewed 50 patients (54 coronary lesions) who underwent PCI for ISR, which included 25 DES-ISR lesions. The PCI strategy depended on the interventionalist’s discretion, and DES implantation was performed for 38 (70 %) lesions. Tissue characteristics were assessed qualitatively and quantitatively using the frame showing maximal lumen narrowing (minimal lumen area). In qualitative analysis, OCT detected coexistence of eccentric tissue proliferation and strong signal attenuation (ESA). ESA was observed in six lesions (11 %) in five patients (10 %). Hemodialysis (80 vs. 20 %, p = 0.013) and DES-ISR (100 vs. 40 %, p = 0.0069) were significantly more frequent in ESA patients/lesions than in others. One-year follow-up revealed that re-TLR was more frequently performed for ESA lesions (83 vs. 8 %, p = 0.0002). The findings reveal that ESA detected in OCT images of ISR is related to TLR after PCI for DES-ISR especially in patients undergoing maintenance hemodialysis.

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Authors and Affiliations

  1. Department of Medicine, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, Japan

    Nobuaki Suzuki, Ken Kozuma, Hiroyuki Kyono, Hiroaki Nakaya, Seiji Nishide, Miho Mitsui, Yugo Nara, Hideyuki Kawashima, Takahiro Nomura, Hirosada Yamamoto & Takaaki Isshiki

  2. Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan

    Yuko Sasajima & Fukuo Kondo

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  1. Nobuaki Suzuki
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  2. Ken Kozuma
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  3. Hiroyuki Kyono
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  4. Hiroaki Nakaya
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  5. Seiji Nishide
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  6. Miho Mitsui
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  7. Yugo Nara
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  8. Hideyuki Kawashima
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  9. Takahiro Nomura
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  10. Hirosada Yamamoto
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  11. Yuko Sasajima
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  13. Takaaki Isshiki
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Correspondence to Nobuaki Suzuki.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Suzuki, N., Kozuma, K., Kyono, H. et al. The clinical characteristics and prognosis of lesions with in-stent eccentric tissue proliferation and strong signal attenuation detected by optical coherence tomography. Cardiovasc Interv and Ther 31, 210–217 (2016). https://doi.org/10.1007/s12928-015-0369-6

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  • DOI: https://doi.org/10.1007/s12928-015-0369-6

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