Differences between first-generation and second-generation drug-eluting stent regarding in-stent neoatherosclerosis characteristics: an optical coherence tomography analysis.
We compared first-generation and second-generation drug-eluting stent (DES) with respect to neoatherosclerosis using optical coherence tomography or optical frequency domain imaging. In-stent restenoses in 102 first-generation and 114 second-generation DES were retrospectively assessed. Neoatherosclerosis, which was defined as the presence of lipid-laden neointima or calcification inside a stent, was observed in 33 (27.2%) and 31 (32.4%) lesions in the first-generation and second-generation DES respectively. In the first-generation DES group, the lipid length was significantly longer (5.5 ± 3.8 vs. 3.1 ± 2.1 mm, P = 0.0007), the lipid arc was significantly larger (324 ± 70° vs. 250 ± 94°, P = 0.002), the prevalence of a 360° lipid arc was significantly greater (58 vs. 31%, P = 0.03), and the fibrous cap was significantly thinner (153 ± 85 vs. 211 ± 95 µm, P = 0.02) compared with those in the second-generation DES group. These differences remained significant after adjusting for the age of the stent (lipid length: P < 0.001; lipid arc: P = 0.019; and fibrous cap thickness: P < 0.001). The proliferation course and stability of neoatherosclerosis over time might be superior in second-generation DES.
['Kobayashi|Norihiro|N|http://orcid.org/0000-0003-1254-0621', 'Ito|Yoshiaki|Y|', 'Yamawaki|Masahiro|M|', 'Araki|Motoharu|M|', 'Sakai|Tsuyoshi|T|', 'Obokata|Masaru|M|', 'Sakamoto|Yasunari|Y|', 'Mori|Shinsuke|S|', 'Tsutsumi|Masakazu|M|', 'Nauchi|Masahiro|M|', 'Honda|Yohsuke|Y|', 'Tokuda|Takahiro|T|', 'Makino|Kenji|K|', 'Shirai|Shigemitsu|S|', 'Hirano|Keisuke|K|']
D000368:Aged D000369:Aged, 80 and over D050197:Atherosclerosis D023903:Coronary Restenosis D003331:Coronary Vessels D054855:Drug-Eluting Stents D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D058426:Neointima D061848:Optical Imaging D062645:Percutaneous Coronary Intervention D012008:Recurrence D012086:Reoperation D012189:Retrospective Studies D041623:Tomography, Optical Coherence D061205:Vascular Calcification
Second-generation drug-eluting stent Neoatherosclerosis Optical coherence tomography Optical frequency domain imaging First-generation drug-eluting stent