Microbubble contrast enhancement of neointima after drug-eluting stent implantation: an optical coherence tomography study
- 28 Downloads
Microvessels within neoatherosclerosis are associated with vulnerability and increase from the early to the very late phase after drug-eluting stent implantation. Microbubble contrast agents have been suggested to enhance tissue microvasculature for optical coherence tomography (OCT) imaging. The present study investigated whether OCT signal intensity of neointima within stented segments was enhanced after intracoronary administration of microbubble contrast agents. A total of 40 patients who underwent follow-up coronary angiography after drug-eluting stent implantation were enrolled. At the time of follow-up coronary angiography, OCT images of the stented segments were recorded before and after intracoronary administration of microbubble contrast agents. Mean OCT signal intensity of neointima after microbubble administration significantly increased [95.5 (85.7, 106.2) vs. 96.5 (88.7, 109.9), p = 0.001]. Multivariate analysis demonstrated the relationship between diabetes and greater neointima enhancement. The change in the OCT signal intensity of neointima following microbubble administration tended to be higher in diabetic patients than in non-diabetic patients [4.6 (0.6, 8.5) vs. 1.4 (− 1.1, 3.0), p = 0.05]. These findings suggest that this methodology may allow identification of neovascularization in neointima and evaluation of vulnerability of neoatherosclerosis. Microvessels in neointima may be a future target of pharmacological and interventional innovations for preventing stent failure.
KeywordsNeointima Neoatherosclerosis Microvessel Optical coherence tomography Microbubble
Optical coherence tomography
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 4.Habara M, Terashima M, Nasu K, Kaneda H, Yokota D, Ito T, Kurita T, Teramoto T, Kimura M, Kinoshita Y, Tsuchikane E, Asakura Y, Suzuki T (2013) Morphological differences of tissue characteristics between early, late, and very late restenosis lesions after first generation drug-eluting stent implantation: an optical coherence tomography study. Eur Heart J Cardiovasc Imaging 14:276–284CrossRefPubMedGoogle Scholar
- 5.Taruya A, Tanaka A, Nishiguchi T, Matsuo Y, Ozaki Y, Kashiwagi M, Shiono Y, Orii M, Yamano T, Ino Y, Hirata K, Kubo T, Akasaka T (2015) Vasa vasorum restructuring in human atherosclerotic plaque vulnerability: a clinical optical coherence tomography study. J Am Coll Cardiol 65:2469–2477CrossRefPubMedGoogle Scholar
- 6.Suzuki N, Kozuma K, Kyono H, Otsuki S, Fu Q, Hosogoe N, Saito T, Naito K, Ochiai M, Ishikawa S, Watanabe H, Miyazawa A, Eto K, Isshiki T (2013) Predominant microvessel proliferation in coronary stent restenotic tissue in patients with diabetes: insights from optical coherence tomography image analysis. Int J Cardiol 168:843–847CrossRefPubMedGoogle Scholar
- 8.Staub D, Patel MB, Tibrewala A, Ludden D, Johnson M, Espinosa P, Coll B, Jaeger KA, Feinstein SB (2010) Vasa vasorum and plaque neovascularization on contrast-enhanced carotid ultrasound imaging correlates with cardiovascular disease and past cardiovascular events. Stroke 41:41–47CrossRefPubMedGoogle Scholar
- 14.Tearney GJ, Regar E, Akasaka T, Adriaenssens T, Barlis P, Bezerra HG, Bouma B, Bruining N, Cho JM, Chowdhary S, Costa MA, De Silva R, Dijkstra J, Di Mario C, Dudeck D, Falk E, Feldman MD, Fitzgerald P, Garcia H, Gonzalo N, Granada JF, Guagliumi G, Holm NR, Honda Y, Ikeno F, Kawasaki M, Kochman J, Koltowski L, Kubo T, Kume T, Kyono H, Lam CCS, Lamouche G, Lee DP, Leon MB, Maehara A, Manfrini O, Mintz GS, Mizuno K, Morel MA, Nadkarni S, Okura H, Otake H, Pietrasik A, Prati F, Rber L, Radu MD, Rieber J, Riga M, Rollins A, Rosenberg M, Sirbu V, Serruys PWJC, Shimada K, Shinke T, Shite J, Siegel E, Sonada S, Suter M, Takarada S, Tanaka A, Terashima M, Troels T, Uemura S, Ughi GJ, Van Beusekom HMM, Van Der Steen AFW, Van Es GA, Van Soest G, Virmani R, Waxman S, Weissman NJ, Weisz G (2012) Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol 59:1058–1072. https://doi.org/10.1016/j.jacc.2011.09.079 CrossRefPubMedGoogle Scholar
- 15.Di Vito L, Yoon JH, Kato K, Yonetsu T, Vergallo R, Costa M, Bezerra HG, Arbustini E, Narula J, Crea F, Prati F, Jang I-K, COICO Group (Consortium of Investigators for Coronary OCT) (2014) Comprehensive overview of definitions for optical coherence tomography-based plaque and stent analyses. Coron Artery Dis 25:172–185CrossRefPubMedGoogle Scholar
- 16.Kitabata H, Tanaka A, Kubo T, Takarada S, Kashiwagi M, Tsujioka H, Ikejima H, Kuroi A, Kataiwa H, Ishibashi K, Komukai K, Tanimoto T, Ino Y, Hirata K, Nakamura N, Mizukoshi M, Imanishi T, Akasaka T (2010) Relation of microchannel structure identified by optical coherence tomography to plaque vulnerability in patients with coronary artery disease. Am J Cardiol 105:1673–1678CrossRefPubMedGoogle Scholar
- 19.Gao L, Park S-J, Jang Y, Lee S, Kim C-J, Minami Y, Ong D, Soeda T, Vergallo R, Lee H, Yu B, Uemura S, Jang I-K (2015) Comparison of neoatherosclerosis and neovascularization between patients with and without diabetes: an optical coherence tomography study. JACC Cardiovasc Interv 8:1044–1052CrossRefPubMedGoogle Scholar
- 20.Nakamura D, Lee Y, Yoshimura T, Taniike M, Makino N, Kato H, Egami Y, Shutta R, Tanouchi J, Yamada Y, Hara M, Sakata Y, Hamasaki T, Nishino M (2014) Different serial changes in the neointimal condition of sirolimus-eluting stents and paclitaxel-eluting stents: an optical coherence tomographic study. EuroIntervention 10:924–933. https://doi.org/10.4244/EIJV10I8A159 CrossRefPubMedGoogle Scholar
- 21.Kubo T, Akasaka T, Tanimoto T, Takano M, Seino Y, Nasu K, Itoh T, Mizuno K, Okura H, Shinke T, Kotani JI, Ito S, Yokoi H, Muramatsu T, Nakamura M, Nanto S (2016) Assessment of vascular response after drug-eluting stents implantation in patients with diabetes mellitus: an optical coherence tomography sub-study of the J-DESsERT. Heart Vessels 31:465–473. https://doi.org/10.1007/s00380-015-0636-6 CrossRefPubMedGoogle Scholar