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Morphological characteristics of in-stent restenosis with different degrees of area stenosis: an optical coherence tomography study

  • 0Department of Cardiology, Affiliated Hospital of Zunyi Medical University, No. 149, Dalian Road, Zunyi City, 563000, China.
The International Journal of Cardiovascular Imaging +

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February 28, 2024

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February 28, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

In-stent restenosis (ISR) shows more complex tissue characteristics with increasing area stenosis (AS). Higher AS is linked to dyslipidemia, neointimal rupture, and thrombus, indicating advanced ISR progression.

Area Of Science

  • Cardiovascular Research
  • Medical Imaging
  • Interventional Cardiology

Background

  • In-stent restenosis (ISR) is a significant complication following percutaneous coronary intervention.
  • The relationship between the degree of area stenosis (AS) and the morphological characteristics of ISR requires further investigation.

Purpose Of The Study

  • To investigate the tissue characteristics of ISR using optical coherence tomography (OCT) across varying degrees of AS.
  • To identify morphological features associated with higher AS in ISR patients.

Main Methods

  • A cohort of 230 ISR patients undergoing OCT were categorized into three groups based on AS severity (<70%, 70-80%, ≥80%).
  • Clinical presentations and OCT-derived morphological findings were analyzed.
  • Ordinal logistic regression was used to identify factors associated with higher AS.

Main Results

  • Higher AS was associated with a higher prevalence of stable angina.
  • OCT revealed increased prevalence of heterogeneous neointima, intra-stent neointimal avascularity (ISNA), lipid-rich plaque (LRP), neointimal rupture, thin-cap fibroatheroma (TCFA)-like patterns, macrophage infiltration, and red/white thrombus with increasing AS.
  • Higher AS was significantly associated with previous dyslipidemia, neointimal rupture, red thrombus, and white thrombus.

Conclusions

  • Patients with higher AS in ISR exhibit more complex morphological features on OCT.
  • Previous dyslipidemia, neointimal rupture, and thrombus presence are strongly associated with the progression of ISR lesions.

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