Impact of low tissue backscattering by optical coherence tomography on endothelial function after drug-eluting stent implantation
- 35 Downloads
This study evaluated the impact of optical coherence tomography (OCT)-derived low-backscattered tissue on mid-term coronary endothelial function after drug-eluting stent (DES) implantation. Although OCT enables detailed in vivo evaluation of neointimal tissue characterization after DES implantation, its association with physiological vascular healing response is unclear. Thirty-three stable angina pectoris patients underwent OCT examination and endothelial function testing with intracoronary infusion of incremental doses of acetylcholine 8-month after DES implantation in a single lesion of the left anterior descending artery. Neointimal tissue was classified into two patterns based on the predominant OCT light backscatter: high backscatter and low backscatter. Although the presence of uncovered or malapposed stent strut was not associated with the degree of vasoconstriction, the degree of vasoconstriction was significantly greater in the DES with low-backscattered neointima than in the DES without low-backscattered neointima (− 32.1 ± 25.7 vs. − 4.1 ± 20.1%, p = 0.003). Moreover, there was an inverse linear relationship between low backscatter tissue index and degree of vasoconstriction after acetylcholine infusion (r = 0.50 and p = 0.003). The endothelium-dependent vasomotor response after 8-month of DES was impaired in patients with low neointimal tissue backscatter on OCT imaging. OCT assessment of low-backscattered tissue may be used as surrogate markers for impairment of endothelial function after DES.
KeywordsDrug-eluting stent Endothelial function Optical coherence tomography
The authors thank the staff in the catheterization laboratory in Hyogo College of Medicine for their excellent assistance during the study.
Compliance with ethical standards
Conflict of interest
The authors report no financial relationships or conflicts of interest regarding the content herein.
- 4.Tada T, Kadota K, Hosogi S, Miyake K, Amano H, Nakamura M, et al. Association between tissue characteristics evaluated with optical coherence tomography and mid-term results after paclitaxel-coated balloon dilatation for in-stent restenosis lesions: a comparison with plain old balloon angioplasty. Eur Heart J Cardiovasc Imaging. 2014;15:307–15.CrossRefPubMedGoogle Scholar
- 9.Fujii K, Masutani M, Okumura T, Kawasaki D, Akagami T, Ezumi A, et al. Frequency and predictor of coronary thin-cap fibroatheroma in patients with acute myocardial infarction and stable angina pectoris a 3-vessel optical coherence tomography study. J Am Coll Cardiol. 2008;52:787–8.CrossRefPubMedGoogle Scholar
- 24.Nakata T, Fujii K, Fukunaga M, Shibuya M, Kawai K, Kawasaki D, et al. Morphological, functional, and biological vascular healing response 6 months after drug-eluting stent implantation: a randomized comparison of three drug-eluting stents. Catheter Cardiovasc Interv. 2016;88:350–7.CrossRefPubMedGoogle Scholar
- 29.Sumida A, Gogas BD, Nagai H, et al. A comparison of drug eluting stent biocompatibility between third generation NOBORI biolimus A9-eluting stent and second generation XIENCE V everolimus-eluting stent in a porcine coronary artery model. Cardiovasc Revasc Med. 2015;16:351–7.CrossRefPubMedGoogle Scholar