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Rentzsch A, Metz E, Mühl-Benninghaus R, Maßmann A, Bettink S, Scheller B, Lemke L, Awadelkareem A, Tomori T, Haidar A, Laschke MW, Menger MD, Aktas C, Hannig M, Pütz N, Büttner T, Scheschkewitz D, Veith M, Abdul-Khaliq H. In vivo biocompatibility of a new hydrophobic coated Al/Al 2O 3 nanowire surface on stents. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2024:S1553-8389(24)00639-0. [PMID: 39217007 DOI: 10.1016/j.carrev.2024.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 08/03/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Intima proliferation and in-stent restenosis is a challenging situation in interventional treatment of small vessel obstruction. Al/Al2O3 nanowires have been shown to accelerate vascular endothelial cell proliferation and migration in vitro, while suppressing vascular smooth muscle cell growth. Moreover, surface modification of Al/Al2O3 nanowires with poly[bis(2,2,2-trifluoromethoxy)phosphazene (PTFEP) coating enables further advantages such as reduced platelet adhesion. Therefore, the study's goal was to compare the biocompatibility of novel Al/Al2O3 + PTFEP coated nanowire bare-metal stents to uncoated control stents in vivo using optical coherence tomography (OCT), quantitative angiography and histomorphometric assessment. METHODS 15 Al/Al2O3 + PTFEP coated and 19 control stents were implanted in the cervical arteries of 9 Aachen minipigs. After 90 days, in-stent stenosis, thrombogenicity, and inflammatory response were assessed. Scanning electron microscopy was used to analyse the stent surface. RESULTS OCT analysis revealed that neointimal proliferation in Al/Al2O3 + PTFEP coated stents was significantly reduced compared to control stents. The neointimal area was 1.16 ± 0.77 mm2 in Al/Al2O3 + PTFEP coated stents vs. 1.98 ± 1.04 mm2 in control stents (p = 0.004), and the neointimal thickness was 0.28 ± 0.20 vs. 0.47 ± 0.10 (p = 0.003). Quantitative angiography showed a tendency to less neointimal growth in coated stents. Histomorphometry showed no significant difference between the two groups and revealed an apparent inflammatory reaction surrounding the stent struts. CONCLUSIONS At long-term follow-up, Al/Al2O3 + PTFEP coated stents placed in peripheral arteries demonstrated good tolerance with no treatment-associated vascular obstruction and reduced in-stent restenosis in OCT. These preliminary in vivo findings indicate that Al/Al2O3 + PTFEP coated nanowire stents may have translational potential to be used for the prevention of in-stent restenosis.
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Affiliation(s)
- Axel Rentzsch
- Clinic for Pediatric Cardiology, Saarland University Hospital, Homburg, Saar, Germany.
| | - Eva Metz
- Clinic for Pediatric Cardiology, Saarland University Hospital, Homburg, Saar, Germany
| | | | - Alexander Maßmann
- Department of Radiology and Nuclear Imaging, Robert Bosch Hospital, Stuttgart, Germany
| | - Stephanie Bettink
- Clinical and Experimental Interventional Cardiology, Saarland University Hospital, Homburg, Saar, Germany
| | - Bruno Scheller
- Clinical and Experimental Interventional Cardiology, Saarland University Hospital, Homburg, Saar, Germany
| | - Lilia Lemke
- Clinic for Pediatric Cardiology, Saarland University Hospital, Homburg, Saar, Germany; Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Homburg, Saar, Germany
| | - Ali Awadelkareem
- Clinic for Pediatric Cardiology, Saarland University Hospital, Homburg, Saar, Germany
| | - Toshiki Tomori
- Department of Neuroradiology, Saarland University Hospital, Homburg, Saar, Germany
| | - Ayman Haidar
- Clinic for Pediatric Cardiology, Saarland University Hospital, Homburg, Saar, Germany
| | - Matthias W Laschke
- Institute for Clinical and Experimental Surgery, Saarland University Hospital, Homburg, Saar, Germany
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University Hospital, Homburg, Saar, Germany
| | - Cenk Aktas
- Institute for Materials Science, Faculty of Engineering, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Homburg, Saar, Germany
| | - Norbert Pütz
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Homburg, Saar, Germany
| | - Thomas Büttner
- General and Inorganic Chemistry, Saarland University, Saarbrücken, Germany
| | | | - Michael Veith
- INM - Leibniz Institute for New Materials, Campus D2 2, Saarbrücken, Germany; General and Inorganic Chemistry, Saarland University, Saarbrücken, Germany
| | - Hashim Abdul-Khaliq
- Clinic for Pediatric Cardiology, Saarland University Hospital, Homburg, Saar, Germany
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Araki M, Park SJ, Dauerman HL, Uemura S, Kim JS, Di Mario C, Johnson TW, Guagliumi G, Kastrati A, Joner M, Holm NR, Alfonso F, Wijns W, Adriaenssens T, Nef H, Rioufol G, Amabile N, Souteyrand G, Meneveau N, Gerbaud E, Opolski MP, Gonzalo N, Tearney GJ, Bouma B, Aguirre AD, Mintz GS, Stone GW, Bourantas CV, Räber L, Gili S, Mizuno K, Kimura S, Shinke T, Hong MK, Jang Y, Cho JM, Yan BP, Porto I, Niccoli G, Montone RA, Thondapu V, Papafaklis MI, Michalis LK, Reynolds H, Saw J, Libby P, Weisz G, Iannaccone M, Gori T, Toutouzas K, Yonetsu T, Minami Y, Takano M, Raffel OC, Kurihara O, Soeda T, Sugiyama T, Kim HO, Lee T, Higuma T, Nakajima A, Yamamoto E, Bryniarski KL, Di Vito L, Vergallo R, Fracassi F, Russo M, Seegers LM, McNulty I, Park S, Feldman M, Escaned J, Prati F, Arbustini E, Pinto FJ, Waksman R, Garcia-Garcia HM, Maehara A, Ali Z, Finn AV, Virmani R, Kini AS, Daemen J, Kume T, Hibi K, Tanaka A, Akasaka T, Kubo T, Yasuda S, Croce K, Granada JF, Lerman A, Prasad A, Regar E, Saito Y, Sankardas MA, Subban V, Weissman NJ, Chen Y, Yu B, Nicholls SJ, Barlis P, West NEJ, Arbab-Zadeh A, Ye JC, Dijkstra J, Lee H, Narula J, Crea F, Nakamura S, Kakuta T, Fujimoto J, Fuster V, Jang IK. Optical coherence tomography in coronary atherosclerosis assessment and intervention. Nat Rev Cardiol 2022; 19:684-703. [PMID: 35449407 PMCID: PMC9982688 DOI: 10.1038/s41569-022-00687-9] [Citation(s) in RCA: 146] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 02/07/2023]
Abstract
Since optical coherence tomography (OCT) was first performed in humans two decades ago, this imaging modality has been widely adopted in research on coronary atherosclerosis and adopted clinically for the optimization of percutaneous coronary intervention. In the past 10 years, substantial advances have been made in the understanding of in vivo vascular biology using OCT. Identification by OCT of culprit plaque pathology could potentially lead to a major shift in the management of patients with acute coronary syndromes. Detection by OCT of healed coronary plaque has been important in our understanding of the mechanisms involved in plaque destabilization and healing with the rapid progression of atherosclerosis. Accurate detection by OCT of sequelae from percutaneous coronary interventions that might be missed by angiography could improve clinical outcomes. In addition, OCT has become an essential diagnostic modality for myocardial infarction with non-obstructive coronary arteries. Insight into neoatherosclerosis from OCT could improve our understanding of the mechanisms of very late stent thrombosis. The appropriate use of OCT depends on accurate interpretation and understanding of the clinical significance of OCT findings. In this Review, we summarize the state of the art in cardiac OCT and facilitate the uniform use of this modality in coronary atherosclerosis. Contributions have been made by clinicians and investigators worldwide with extensive experience in OCT, with the aim that this document will serve as a standard reference for future research and clinical application.
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Affiliation(s)
| | | | | | | | - Jung-Sun Kim
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Thomas W Johnson
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | | | - Adnan Kastrati
- Technische Universität München and Munich Heart Alliance, Munich, Germany
| | | | | | | | - William Wijns
- National University of Ireland Galway and Saolta University Healthcare Group, Galway, Ireland
| | | | | | - Gilles Rioufol
- Hospices Civils de Lyon and Claude Bernard University, Lyon, France
| | | | | | | | | | | | - Nieves Gonzalo
- Hospital Clinico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain
| | | | - Brett Bouma
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Gary S Mintz
- Cardiovascular Research Foundation, New York, NY, USA
| | - Gregg W Stone
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christos V Bourantas
- Barts Health NHS Trust, University College London and Queen Mary University London, London, UK
| | - Lorenz Räber
- Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | | | | | | | - Myeong-Ki Hong
- Yonsei University College of Medicine, Seoul, South Korea
| | - Yangsoo Jang
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Bryan P Yan
- Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Italo Porto
- University of Genoa, Genoa, Italy, San Martino Hospital, IRCCS for Oncology and Neurosciences, Genoa, Italy
| | | | - Rocco A Montone
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | | | | | - Harmony Reynolds
- New York University Grossman School of Medicine, New York, NY, USA
| | - Jacqueline Saw
- Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter Libby
- Brigham and Women's Hospital, Boston, MA, USA
| | - Giora Weisz
- New York Presbyterian Hospital, Columbia University Medical Center and Cardiovascular Research Foundation, New York, NY, USA
| | | | - Tommaso Gori
- Universitäts medizin Mainz and DZHK Rhein-Main, Mainz, Germany
| | | | | | | | | | | | - Osamu Kurihara
- Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | | | | | | | - Tetsumin Lee
- Japanese Red Cross Musashino Hospital, Tokyo, Japan
| | - Takumi Higuma
- Kawasaki Municipal Tama Hospital, St. Marianna University School of Medicine, Kanagawa, Japan
| | | | - Erika Yamamoto
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Krzysztof L Bryniarski
- Jagiellonian University Medical College, Institute of Cardiology, Department of Interventional Cardiology, John Paul II Hospital, Krakow, Poland
| | | | | | | | - Michele Russo
- Catholic University of the Sacred Heart, Rome, Italy
| | | | | | - Sangjoon Park
- Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Marc Feldman
- University of Texas Health, San Antonio, TX, USA
| | | | - Francesco Prati
- UniCamillus - Saint Camillus International University of Health Sciences, Rome, Italy
| | - Eloisa Arbustini
- IRCCS Foundation University Hospital Policlinico San Matteo, Pavia, Italy
| | - Fausto J Pinto
- Santa Maria University Hospital, CHULN Center of Cardiology of the University of Lisbon, Lisbon School of Medicine, Lisbon Academic Medical Center, Lisbon, Portugal
| | - Ron Waksman
- MedStar Washington Hospital Center, Washington, DC, USA
| | | | - Akiko Maehara
- Cardiovascular Research Foundation, New York, NY, USA
| | - Ziad Ali
- Cardiovascular Research Foundation, New York, NY, USA
| | | | | | | | - Joost Daemen
- Erasmus University Medical Centre, Rotterdam, Netherlands
| | | | - Kiyoshi Hibi
- Yokohama City University Medical Center, Kanagawa, Japan
| | | | | | | | - Satoshi Yasuda
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kevin Croce
- Brigham and Women's Hospital, Boston, MA, USA
| | | | | | | | | | | | | | | | | | - Yundai Chen
- Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Bo Yu
- The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | | | - Peter Barlis
- University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Jong Chul Ye
- Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | | | - Hang Lee
- Massachusetts General Hospital, Boston, MA, USA
| | - Jagat Narula
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Filippo Crea
- Catholic University of the Sacred Heart, Rome, Italy
| | | | | | - James Fujimoto
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Ik-Kyung Jang
- Massachusetts General Hospital, Boston, MA, USA.
- Kyung Hee University, Seoul, South Korea.
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Mattesini A, Demola P, Shlofmitz R, Shlofmitz E, Waksman R, Jaffer FA, Di Mario C. Optical Coherence Tomography, Near‐Infrared Spectroscopy, and Near‐Infrared Fluorescence Molecular Imaging. Interv Cardiol 2022. [DOI: 10.1002/9781119697367.ch9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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4
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Jimenez-Quevedo P, Bernardo E, Del Trigo M, Otsuki S, Nombela-Franco L, Brugaletta S, Ortega-Pozi A, Herrera R, Salinas P, Nuñez-Gil I, Mejía-Rentería H, Alfonso F, Fernandez-Perez C, Fernandez-Ortiz A, Macaya C, Escaned J, Sabate M, Gonzalo N. Vascular Injury After Stenting - Insights of Systemic Mechanisms of Vascular Repair. Circ J 2022; 86:966-974. [PMID: 34853277 DOI: 10.1253/circj.cj-21-0649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The role of circulating progenitor cells (CPC) in vascular repair following everolimus-eluting stent (EES) implantation is largely unknown. The aim of the study was to investigate the relationship between temporal variation in CPC levels following EES implantation and the degree of peri-procedural vascular damage, and stent healing, as measured by optical coherence tomography (OCT). METHODS AND RESULTS CPC populations (CD133+/KDR+/CD45low) included patients with stable coronary artery disease undergoing stent implantation, and were evaluated using a flow cytometry technique both at baseline and at 1 week. OCT evaluation was performed immediately post-implantation to quantify the stent-related injury and at a 9-month follow up to assess the mid-term vascular response. Twenty patients (mean age 66±9 years; 80% male) with EES-treated stenoses (n=24) were included in this study. Vascular injury score was associated with the 1-week increase of CD133+/KDR+/CD45low (β 0.28 [95% CI 0.15; 0.41]; P<0.001) and with maximum neointimal thickness at a 9-month follow up (β 0.008 [95% CI 0.0004; 0.002]; P=0.04). Inverse relationships between numbers of uncoated and apposed struts for the 9-month and the 1-week delta values of CD133+/KDR+/CD45low (β -12.53 [95% CI -22.17; -2.90]; P=0.011), were also found. CONCLUSIONS The extent of vessel wall injury influences early changes in the levels of CPC and had an effect on mid-term vascular healing after EES implantation. Early CPC mobilisation was associated with mid-term strut coverage.
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Affiliation(s)
| | | | | | - Shuji Otsuki
- University Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)
| | | | - Salvatore Brugaletta
- University Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)
| | | | | | | | | | | | | | | | | | | | | | - Manel Sabate
- University Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)
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5
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Kunio M, Gardecki JA, Watanabe K, Nishimiya K, Verma S, Jaffer FA, Tearney GJ. Histopathological correlation of near infrared autofluorescence in human cadaver coronary arteries. Atherosclerosis 2022; 344:31-39. [PMID: 35134654 PMCID: PMC9106423 DOI: 10.1016/j.atherosclerosis.2022.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/21/2021] [Accepted: 01/18/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Prior coronary optical coherence tomography (OCT)-near infrared auto-fluorescence (NIRAF) imaging data has shown a correlation between high-risk morphological features and NIRAF signal intensity. This study aims to understand the histopathological origins of NIRAF in human cadaver coronary arteries. METHODS Ex vivo intracoronary OCT-NIRAF imaging was performed on coronary arteries prosected from 23 fresh human cadaver hearts. Arteries with elevated NIRAF were formalin-fixed and paraffin-embedded. Microscopic images of immunostained Glycophorin A (indicating intraplaque hemorrhage) and Sudan Black (indicating ceroid after fixation) stained slides were compared with confocal NIRAF images (ex. 635 nm, em. 655-755 nm) from adjacent unstained slides in each section. Different images from the same section were registered via luminal morphology. Confocal NIRAF-positive 45° sectors were compared to immunohistochemistry and colocalization between NIRAF and intraplaque hemorrhage or ceroid was quantified by Manders' overlap and Dice similarity coefficients. RESULTS Thirty-one coronary arteries from 14 hearts demonstrated ≥1.5 times higher NIRAF signal than background, and 429 sections were created from them, including 54 sections (12.6%) with high-risk plaques. Within 112 confocal NIRAF-positive 45° sectors, 65 sectors (58.0%) showed both Glycophorin A-positive and Sudan Black-positive, while 7 sectors (6.3%) and 40 sectors (33.6%) only showed Glycophorin A-positive or Sudan black-positive, respectively. A two-tailed McNemar's test showed that Sudan Black more closely corresponded to confocal NIRAF than Glycophorin A (p < 1.0 × 10-6). NIRAF was also found to spatially associate with both Glycophorin A and Sudan Black, with stronger colocalization between Sudan Black and NIRAF (Manders: 0.19 ± 0.15 vs. 0.13 ± 0.14, p < 0.005; Dice: 0.072 ± 0.096 vs. 0.060 ± 0.090, p < 0.01). CONCLUSIONS As ceroid associates with oxidative stress and intraplaque hemorrhage is implicated in rapid lesion progression, these results suggest that NIRAF provides additional, complementary information to morphologic imaging that may aid in identifying high-risk coronary plaques via translatable intracoronary OCT-NIRAF imaging.
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Affiliation(s)
- Mie Kunio
- Canon U.S.A., Inc., Cambridge, MA, USA; Wellman Center of Photomedicine, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| | - Joseph A. Gardecki
- Wellman Center of Photomedicine, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kohei Watanabe
- Canon U.S.A., Inc., Cambridge, MA, USA,Wellman Center of Photomedicine, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Kensuke Nishimiya
- Wellman Center of Photomedicine, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Farouc A. Jaffer
- Wellman Center of Photomedicine, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Cardiovascular Research Center, Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Guillermo J. Tearney
- Wellman Center of Photomedicine, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Corresponding author. 55 Fruit Street, BHX 604A, Boston, MA, 02114, USA. (M. Kunio), (G.J. Tearney)
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Yoshimura J, Kimura M, Ikemura N, Sawada T. Optical Frequency Domain Images of 3 Unique Femoral Artery Stents at 5 Months After Implantation. JACC Cardiovasc Interv 2021; 14:e105-e106. [PMID: 33582085 DOI: 10.1016/j.jcin.2020.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/08/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Jun Yoshimura
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Masayoshi Kimura
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
| | - Nariko Ikemura
- Department of Cardiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Takahisa Sawada
- Department of Cardiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
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Montarello NJ, Nelson AJ, Verjans J, Nicholls SJ, Psaltis PJ. The role of intracoronary imaging in translational research. Cardiovasc Diagn Ther 2020; 10:1480-1507. [PMID: 33224769 DOI: 10.21037/cdt-20-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Atherosclerotic cardiovascular disease is a key public health concern worldwide and leading cause of morbidity, mortality and health economic costs. Understanding atherosclerotic plaque microstructure in relation to molecular mechanisms that underpin its initiation and progression is needed to provide the best chance of combating this disease. Evolving vessel wall-based, endovascular coronary imaging modalities, including intravascular ultrasound (IVUS), optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS), used in isolation or as hybrid modalities, have been advanced to allow comprehensive visualization of the pathological substrate of coronary atherosclerosis and accurately measure temporal changes in both the vessel wall and plaque characteristics. This has helped further our appreciation of the natural history of coronary artery disease (CAD) and the risk for major adverse cardiovascular events (MACE), evaluate the responsiveness to conventional and experimental therapeutic interventions, and assist in guiding percutaneous coronary intervention (PCI). Here we review the use of different imaging modalities for these purposes and the lessons they have provided thus far.
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Affiliation(s)
- Nicholas J Montarello
- Department of Cardiology, Central Adelaide Local Health Network, Adelaide, Australia
| | - Adam J Nelson
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Duke Clinical Research Institute, Durham, NC, USA
| | - Johan Verjans
- Department of Cardiology, Central Adelaide Local Health Network, Adelaide, Australia.,Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Vascular Research Centre, Heart and Vascular Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Stephen J Nicholls
- Monash Cardiovascular Research Centre, Monash University, Clayton, Australia
| | - Peter J Psaltis
- Department of Cardiology, Central Adelaide Local Health Network, Adelaide, Australia.,Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Vascular Research Centre, Heart and Vascular Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
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Rezvova MA, Ovcharenko EA, Klyshnikov KY, Kudryavtseva YA. Promising polymeric compounds for coronary stent graft membrane. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2020. [DOI: 10.15829/1728-8800-2020-2318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The literature review discusses the studies on developing the polymer membrane of a coronary stent graft. The new generation of coronary stent grafts is designed to increase the hemocompatibility and ensure its delivery to poorly accessible artery regions. Based on the clinical use results, three groups of promising polymers were identified: biostable polyurethanes, polyvinyl alcohol-based cryogels, bioresorbable compositions based on polylactide-caprolactone and lactic acid-glycolic acid copolymer. However, the possibility of their clinical application requires further experimental studying.
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Affiliation(s)
- M. A. Rezvova
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - E. A. Ovcharenko
- Research Institute for Complex Issues of Cardiovascular Diseases
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Nishino S, Sakuma M, Kanaya T, Nasuno T, Tokura M, Toyoda S, Abe S, Nakamura D, Tanaka K, Attizzani GF, Bezerra HG, Costa MA, Inoue T. Neointimal tissue characterization after implantation of drug-eluting stents by optical coherence tomography: quantitative analysis of optical density. Int J Cardiovasc Imaging 2019; 35:1971-1978. [PMID: 31218524 DOI: 10.1007/s10554-019-01651-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 06/13/2019] [Indexed: 11/24/2022]
Abstract
Normalized optical density (NOD) measured by optical coherence tomography represents neointimal maturity after coronary stent implantation and is correlated with morphologic information provided by both light and electron microscopy. We aimed to test the hypothesis that even second generation drug-eluting stents (DESs) are problematic in terms of neointimal maturity. We implanted bare-metal stents (BMS: n = 14), everolimus-eluting stents (EESs: n = 15) or zotarolimus-eluting stents (ZESs: n = 12) at 41 sites in 32 patients with stable coronary artery disease. OCT was performed at up to 12 months of follow-up, and the average optical density of neointima covering struts was evaluated. NOD was calculated as the optical density of stent-strut covering tissue divided by the optical density of the struts. We also measured circulating CD34+ /CD133+ /CD45low cells, and serum levels of stromal cell-derived factor (SDF)-1, interleukin (IL)-8 and matrix metalloproteinase (MMP)-9 at baseline and follow-up. NOD was lower in the EES (0.70 ± 0.06) group than in the BMS (0.76 ± 0.07, P < 0.05) and ZES (0.76 ± 0.06, P < 0.05) groups. The mean neointimal area (R = 0.33, P < 0.05) and mean neointimal thickness (R = 0.37, P < 0.05) were correlated with NOD. Although NOD was not correlated with percent changes in circulating endothelial progenitor cells, and the levels of SDF-1 and IL-8, it was negatively correlated with the change in MMP-9 level (R = - 0.51, P < 0.01). Neointimal maturity might be lower at EES sites than BMS or ZES sites. This might lead to impaired neointimal tissue growth and matrix degradation. These results suggest a specific pathophysiology after DES implantation.
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Affiliation(s)
- Setsu Nishino
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan. .,Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
| | - Masashi Sakuma
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Tomoaki Kanaya
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Takahisa Nasuno
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Michiaki Tokura
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Shichiro Abe
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
| | - Daisuke Nakamura
- Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Kentaro Tanaka
- Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Guiherme F Attizzani
- Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Hiram G Bezerra
- Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Marco A Costa
- Cardiovascular Imaging Core Laboratory, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Teruo Inoue
- Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan
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Ali ZA, Karimi Galougahi K, Maehara A, Shlofmitz RA, Ben-Yehuda O, Mintz GS, Stone GW. Intracoronary Optical Coherence Tomography 2018: Current Status and Future Directions. JACC Cardiovasc Interv 2019; 10:2473-2487. [PMID: 29268880 DOI: 10.1016/j.jcin.2017.09.042] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 09/13/2017] [Indexed: 01/14/2023]
Abstract
The advent of intravascular imaging has been a significant advancement in visualization of coronary arteries, particularly with optical coherence tomography (OCT) that allows for high-resolution imaging of intraluminal and transmural coronary structures. Accumulating data support a clinical role for OCT in a multitude of clinical scenarios, including assessing the natural history of atherosclerosis and modulating effects of therapies, mechanisms of acute coronary syndromes, mechanistic insights into the effects of novel interventional devices, and optimization of percutaneous coronary intervention. In this state-of-the-art review, we provide an overview of the published data on the clinical utility of OCT, highlighting the areas that need further investigation and the current barriers for further adoption of OCT in interventional cardiology practice.
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Affiliation(s)
- Ziad A Ali
- Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York; Cardiovascular Research Foundation, New York, New York.
| | - Keyvan Karimi Galougahi
- Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York
| | - Akiko Maehara
- Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York; Cardiovascular Research Foundation, New York, New York
| | | | - Ori Ben-Yehuda
- Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York; Cardiovascular Research Foundation, New York, New York
| | - Gary S Mintz
- Cardiovascular Research Foundation, New York, New York
| | - Gregg W Stone
- Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, New York; Cardiovascular Research Foundation, New York, New York
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11
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Ali ZA, Galougahi KK, Finn AV. Covering our tracks - optical coherence tomography to assess vascular healing. EUROINTERVENTION 2018; 14:e1247-e1251. [PMID: 30566079 DOI: 10.4244/eijv14i12a224] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ziad A Ali
- Center for Interventional Vascular Therapy, Division of Cardiology, Presbyterian Hospital and Columbia University, New York, NY, USA
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12
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Sato T, Taya Y, Suzuki N, Yuasa S, Kishi S, Koshikawa T, Fuse K, Fujita S, Ikeda Y, Kitazawa H, Takahashi M, Okabe M, Aizawa Y. The comparison of early healing 1-month after PCI among CoCr-everolimus-eluting stent (EES), biodegradable polymer (BP)-EES and BP-sirolimus-eluting stent: Insights from OFDI and coronary angioscopy. IJC HEART & VASCULATURE 2018; 20:40-45. [PMID: 30167453 PMCID: PMC6113672 DOI: 10.1016/j.ijcha.2018.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 07/29/2018] [Accepted: 08/05/2018] [Indexed: 11/25/2022]
Abstract
Background Third-generation stents with abluminal biodegradable polymer (BP) might facilitate early healing. Therefore, we compared early healing between second-generation and third-generation stents using coronary angioscopy (CAS) and optical frequency domain imaging [OFDI]. Methods We prospectively enrolled 30 consecutive patients with stent implantation for acute coronary syndrome (cobalt‑chromium [CoCr] everolimus-eluting stent [EES] [n = 10], BP-EES [n = 10], and BP-sirolimus eluting stent [SES] [n = 10]). All patients underwent CAS and OFDI 1 month after initial percutaneous coronary intervention. On OFDI, the stent coverage (SC), thrombus, and peri-strut low intensity area (PLIA) were assessed. CAS findings were recorded for the grade of SC, grade of yellow color (YC), and grade of the thrombus (TG). Results On OFDI, the incidences of any thrombus at the 1-month follow-up were 70%, 80%, and 80% in the CoCr-EES, BP-EES, and BP-SES groups, respectively. The percentage of coverage was comparable among the groups (CoCr-EES 79.8 vs. BP-EES 79.9 vs. BP-SES 80.1%, P = 0.96). However, the number of struts with PLIA was numerically higher in the BP-SES group than in the CoCr-EES and BP-EES groups (46.4 ± 25.1 vs. 21.6 ± 13.2 vs. 22.0 ± 7.2%, P = 0.08). In the CoCr-EES, BP-EES, and BP-SES groups, mean grades of SC were 1.25 ± 0.5, 1.25 ± 0.5, and 0.85 ± 0.70 (P = 0.60); mean grades of YC were 0.75 ± 0.5, 0.80 ± 0.45, and 0.88 ± 0.37 (P = 0.65), and mean grades of TG were 1.00 ± 1.00, 1.20 ± 0.83, and 0.88 ± 0.64 (P = 0.75), respectively. Conclusion Third-generation stents are not inferior to second-generation stents regarding stent coverage. However, PLIA on OFDI was often observed with BP-SESs, indicating involvement of the fibrin component.
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Affiliation(s)
- Takao Sato
- Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | - Yuji Taya
- Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | | | - Sho Yuasa
- Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | - Shohei Kishi
- Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | | | - Koichi Fuse
- Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | | | - Yoshio Ikeda
- Cardiology, Tachikawa General Hospital, Nagaoka, Japan
| | | | | | - Masaaki Okabe
- Cardiology, Tachikawa General Hospital, Nagaoka, Japan
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13
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Chevalier B, Smits PC, Carrié D, Mehilli J, Van Boven AJ, Regar E, Sawaya FJ, Chamié D, Kraaijeveld AO, Hovasse T, Vlachojannis GJ. Serial Assessment of Strut Coverage of Biodegradable Polymer Drug-Eluting Stent at 1, 2, and 3 Months After Stent Implantation by Optical Frequency Domain Imaging: The DISCOVERY 1TO3 Study (Evaluation With OFDI of Strut Coverage of Terumo New Drug Eluting Stent With Biodegradable Polymer at 1, 2, and 3 Months). Circ Cardiovasc Interv 2018; 10:CIRCINTERVENTIONS.116.004801. [PMID: 29246909 DOI: 10.1161/circinterventions.116.004801] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 10/24/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND To assess the vessel-healing pattern of Ultimaster drug-eluting stent using optical frequency domain imaging. Our hypothesis is that biodegradable polymer-based drug-eluting technology allows complete very early strut coverage. METHODS AND RESULTS The DISCOVERY 1TO3 study (Evaluation With OFDI of Strut Coverage of Terumo New Drug Eluting Stent With Biodegradable Polymer at 1, 2, and 3 Months) is a prospective, single-arm, multicenter study. A total of 60 patients with multivessel disease requiring staged procedure at 1 month were treated with Ultimaster. Optical frequency domain imaging was acquired at baseline, 1, 2, and 3 months. The primary end point is optical frequency domain imaging-assessed strut coverage at 3 months. Mean age of patients was 67.2±9.9 years, and 73.3% were male, and 36.7% presented with acute coronary syndrome. A total of 132 lesions were treated, with average 1.4 lesions per patient treated at baseline and 1.1 lesions treated at 1 month. Strut coverage at 3 months of single implanted stents (n=71, primary end point) was 95.2±5.2% and of combined single and overlapped stents was 95.4±4.9%. Strut coverage of combined single and overlapped stents at 1 (n=49) and 2 months (n=38) was 85.1±12.7% and 87.9±10.8%, respectively. The median neointimal hyperplasia thickness was 0.04, 0.05, and 0.06 mm, whereas mean neointimal hyperplasia obstruction was 4.5±2.4%, 5.2±3.4%, and 6.6±3.3% at 1, 2, and 3 months, respectively. CONCLUSIONS Nearly complete strut coverage was observed in this complex population very early after implantation of Ultimaster drug-eluting stent. CLINICAL TRIAL REGISTRATION URL: https://www.clinicaltrials.gov. Unique identifier: NCT01844843.
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Affiliation(s)
- Bernard Chevalier
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.).
| | - Pieter C Smits
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.)
| | - Didier Carrié
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.)
| | - Julinda Mehilli
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.)
| | - Ad J Van Boven
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.)
| | - Evelyn Regar
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.)
| | - Fadi J Sawaya
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.)
| | - Daniel Chamié
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.)
| | - Adriaan O Kraaijeveld
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.)
| | - Thomas Hovasse
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.)
| | - Georgios J Vlachojannis
- From the Ramsay Générale de Santé, Interventional Cardiology Department, Institut Cardiovasculaire Paris Sud, Massy, France (B.C., F.J.S., T.H.); Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands (P.C.S., A.O.K., G.J.V.); Department of Cardiology, CHU Rangueil, Toulouse, France (D.C.); Department of Cardiology, Munich University Clinic, LMU Munich and Munich Heart Alliance, DZHK, Germany (J.M.); Department of Cardiology, Medisch Centrum Leeuwarden, the Netherlands (A.J.V.B.); The Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (E.R.); and Department of Invasive Cardiology, Institute Dante Pazzanese of Cardiology, Cardiovascular Research Center, Sao Paulo, Brazil (D.C.)
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Puri R, Otaegui I, Sabaté M, Serra-Peñaranda A, Puigfel M, Perez de Prado A, Nombela-Franco L, de la Torre Hernandez JM, Ortas Nadal R, Iniguez-Romo A, Jiménez G, Fernandez-Vazquez F, Cuellas-Ramon C, Gonzalo N, Alfonso Jiménez Diaz V, Duocastella L, Molina M, Amoros M, Perez I, Barria Perez A, Pelletier Beaumont E, Nicholls SJ, Garcia del Blanco B, Rodés-Cabau J. Three- and 6-month optical coherence tomographic surveillance following percutaneous coronary intervention with the Angiolite® drug-eluting stent: The ANCHOR study. Catheter Cardiovasc Interv 2017; 91:435-443. [DOI: 10.1002/ccd.27189] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/11/2017] [Accepted: 06/08/2017] [Indexed: 11/09/2022]
Affiliation(s)
- Rishi Puri
- Department of Cardiology; Quebec Heart and Lung Institute, Laval University; Quebec City Canada
- Cleveland Clinic Coordinating Center for Clinical Research (C5R); Cleveland Ohio
- Department of Medicine; University of Adelaide; Adelaide Australia
| | | | | | | | - Marti Puigfel
- Hospital Universitari de Girona Dr. Josep Trueta; Girona Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Alberto Barria Perez
- Department of Cardiology; Quebec Heart and Lung Institute, Laval University; Quebec City Canada
| | | | - Stephen J. Nicholls
- South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide; Adelaide Australia
| | | | - Josep Rodés-Cabau
- Department of Cardiology; Quebec Heart and Lung Institute, Laval University; Quebec City Canada
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15
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Comparison of in-stent neoatherosclerosis and tissue characteristics between early and late in-stent restenosis in second-generation drug-eluting stents: an optical coherence tomography study. Int J Cardiovasc Imaging 2017; 33:1463-1472. [DOI: 10.1007/s10554-017-1146-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 04/21/2017] [Indexed: 11/24/2022]
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16
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Jaguszewski M, Aloysius R, Wang W, Bezerra HG, Hill J, De Winter RJ, Karjalainen PP, Verheye S, Wijns W, Lüscher TF, Joner M, Costa M, Landmesser U. The REMEDEE-OCT Study. JACC Cardiovasc Interv 2017; 10:489-499. [DOI: 10.1016/j.jcin.2016.11.040] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 11/11/2016] [Accepted: 11/17/2016] [Indexed: 12/24/2022]
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17
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Hara T, Ughi GJ, McCarthy JR, Erdem SS, Mauskapf A, Lyon SC, Fard AM, Edelman ER, Tearney GJ, Jaffer FA. Intravascular fibrin molecular imaging improves the detection of unhealed stents assessed by optical coherence tomography in vivo. Eur Heart J 2017; 38:447-455. [PMID: 26685129 PMCID: PMC5837565 DOI: 10.1093/eurheartj/ehv677] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/14/2015] [Accepted: 11/21/2015] [Indexed: 01/20/2023] Open
Abstract
AIMS Fibrin deposition and absent endothelium characterize unhealed stents that are at heightened risk of stent thrombosis. Optical coherence tomography (OCT) is increasingly used for assessing stent tissue coverage as a measure of healed stents, but cannot precisely identify whether overlying tissue represents physiological neointima. Here we assessed and compared fibrin deposition and persistence on bare metal stent (BMS) and drug-eluting stent (DES) using near-infrared fluorescence (NIRF) molecular imaging in vivo, in combination with simultaneous OCT stent coverage. METHODS AND RESULTS Rabbits underwent implantation of one BMS and one DES without overlap in the infrarenal aorta (N = 20 3.5 × 12 mm). At Days 7 and/or 28, intravascular NIRF-OCT was performed following the injection of fibrin-targeted NIRF molecular imaging agent FTP11-CyAm7. Intravascular NIRF-OCT enabled high-resolution imaging of fibrin overlying stent struts in vivo, as validated by histopathology. Compared with BMS, DES showed greater fibrin deposition and fibrin persistence at Days 7 and 28 (P < 0.01 vs. BMS). Notably, for edge stent struts identified as covered by OCT on Day 7, 92.8 ± 9.5% of DES and 55.8 ± 23.6% of BMS struts were NIRF fibrin positive (P < 0.001). At Day 28, 18.6 ± 10.6% (DES) and 5.1 ± 8.7% (BMS) of OCT-covered struts remained fibrin positive (P < 0.001). CONCLUSION Intravascular NIRF fibrin molecular imaging improves the detection of unhealed stents, using clinically translatable technology that complements OCT. A sizeable percentage of struts deemed covered by OCT are actually covered by fibrin, particularly in DES, and therefore such stents might remain prothrombotic. These findings have implications for the specificity of standalone clinical OCT assessments of stent healing.
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Affiliation(s)
- Tetsuya Hara
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Giovanni J Ughi
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jason R McCarthy
- Center for System Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - S Sibel Erdem
- Center for System Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Adam Mauskapf
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Samantha C Lyon
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ali M Fard
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Farouc A Jaffer
- Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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18
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Tenekecioglu E, Albuquerque FN, Sotomi Y, Zeng Y, Suwannasom P, Tateishi H, Cavalcante R, Ishibashi Y, Nakatani S, Abdelghani M, Dijkstra J, Bourantas C, Collet C, Karanasos A, Radu M, Wang A, Muramatsu T, Landmesser U, Okamura T, Regar E, Räber L, Guagliumi G, Pyo RT, Onuma Y, Serruys PW. Intracoronary optical coherence tomography: Clinical and research applications and intravascular imaging software overview. Catheter Cardiovasc Interv 2017; 89:679-689. [DOI: 10.1002/ccd.26920] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 12/19/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Erhan Tenekecioglu
- Erasmus University Medical Centre, Thoraxcenter; Rotterdam The Netherlands
| | - Felipe N. Albuquerque
- Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine; Atlanta United States
| | - Yohei Sotomi
- Academic Medical Center-University of Amsterdam; Amsterdam The Netherlands
| | - Yaping Zeng
- Erasmus University Medical Centre, Thoraxcenter; Rotterdam The Netherlands
| | - Pannipa Suwannasom
- Erasmus University Medical Centre, Thoraxcenter; Rotterdam The Netherlands
- Academic Medical Center-University of Amsterdam; Amsterdam The Netherlands
| | - Hiroki Tateishi
- Erasmus University Medical Centre, Thoraxcenter; Rotterdam The Netherlands
| | - Rafael Cavalcante
- Erasmus University Medical Centre, Thoraxcenter; Rotterdam The Netherlands
| | - Yuki Ishibashi
- Erasmus University Medical Centre, Thoraxcenter; Rotterdam The Netherlands
| | - Shimpei Nakatani
- Erasmus University Medical Centre, Thoraxcenter; Rotterdam The Netherlands
| | | | - Jouke Dijkstra
- Leiden University Medical Center; Leiden The Netherlands
| | | | - Carlos Collet
- Academic Medical Center-University of Amsterdam; Amsterdam The Netherlands
| | - Antonios Karanasos
- Erasmus University Medical Centre, Thoraxcenter; Rotterdam The Netherlands
| | - Maria Radu
- Copenhagen University Hospital; Copenhagen Denmark
| | - Ancong Wang
- Leiden University Medical Center; Leiden The Netherlands
| | | | | | | | - Evelyn Regar
- Department of Cardiovascular Surgery; University Hospital Zürich; Switzerland
| | | | | | - Robert T. Pyo
- Albert Einstein College of Medicine; Montefiore Medical Center; NY
| | - Yoshinobu Onuma
- Erasmus University Medical Centre, Thoraxcenter; Rotterdam The Netherlands
| | - Patrick W. Serruys
- Erasmus University Medical Centre, Thoraxcenter; Rotterdam The Netherlands
- International Centre for Circulatory Health, Imperial College; London United Kingdom
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19
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Kilic ID, Serdoz R, Fabris E, Jaffer FA, Di Mario C. Optical Coherence Tomography, Near-Infrared Spectroscopy, and Near-Infrared Fluorescence Molecular Imaging. Interv Cardiol 2016. [DOI: 10.1002/9781118983652.ch8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- Ismail Dogu Kilic
- Department of Cardiology; Pamukkale University Hospitals; Denizli Turkey
- National Institute of Health Research (NIHR); Royal Brompton & Harefield NHS Foundation Trust; London
- NHLI Imperial College; London UK
| | - Roberta Serdoz
- National Institute of Health Research (NIHR); Royal Brompton & Harefield NHS Foundation Trust; London
- NHLI Imperial College; London UK
| | - Enrico Fabris
- National Institute of Health Research (NIHR); Royal Brompton & Harefield NHS Foundation Trust; London
- NHLI Imperial College; London UK
- Cardiovascular Department; Ospedali Riuniti and University of Trieste; Trieste Italy
| | - Farouc Amin Jaffer
- Cardiology Division, Massachusetts General Hospital; Harvard Medical School; Boston MA USA
| | - Carlo Di Mario
- National Institute of Health Research (NIHR); Royal Brompton & Harefield NHS Foundation Trust; London
- NHLI Imperial College; London UK
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20
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Takahara M, Kitahara H, Nishi T, Miura K, Miyayama T, Sugimoto K, Nakayama T, Fujimoto Y, Kobayashi Y. Very early tissue coverage after drug-eluting stent implantation: an optical coherence tomography study. Int J Cardiovasc Imaging 2016; 33:25-30. [PMID: 27601229 DOI: 10.1007/s10554-016-0972-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 08/29/2016] [Indexed: 10/21/2022]
Abstract
The aim of this study was to evaluate neointimal coverage in the very early phase after second-generation drug-eluting stent (DES) implantation using optical coherence tomography (OCT). Patients who underwent staged percutaneous coronary intervention within 30 days after DES implantation were enrolled. OCT was performed to observe DES previously implanted. The median time interval from implantation to OCT examination was 21.5 days. A total of 10,625 struts of 54 stents (52 everolimus-eluting stents and 2 zotarolimus-eluting stents) in 42 lesions were analyzed. Strut tissue coverage was observed in 71.1 ± 19.2 % of the struts, malapposed struts in 2.56 ± 3.37 %, strut tissue coverage at the side branch orifice in 10.6 ± 17.2 %, and struts with protrusion in 0.95 ± 3.46 %. Mean tissue thickness on the covered struts was 39.8 ± 14.2 µm. The percentage of stent coverage was significantly lower in the overlapping segments than in the non-overlapping segments (48.4 ± 17.5 % vs. 74.4 ± 20.2 %, P < 0.05). Most of the stent struts were covered by tissue within 30 days after second-generation DES implantation. However, the percentage of strut coverage was lower in the overlapping segments than in the non-overlapping segments, suggesting that very early interruption of dual antiplatelet therapy might result in increased risk of stent thrombosis, even in second-generation DES.
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Affiliation(s)
- Masayuki Takahara
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan.
| | - Hideki Kitahara
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
| | - Takeshi Nishi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
| | - Keiichiro Miura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
| | - Tomoaki Miyayama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
| | - Kazumasa Sugimoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
| | - Takashi Nakayama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
| | - Yoshihide Fujimoto
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan
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21
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Radu MD, Engstrøm T. Casting light on coronary evaginations: different mechanisms in different coronary devices? Eur Heart J 2016; 37:2050-4. [PMID: 26612580 DOI: 10.1093/eurheartj/ehv623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Maria D Radu
- Department of Cardiology, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas Engstrøm
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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22
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Lee SW, Lam SC, Tam FC, Chan KK, Shea CP, Kong SL, Wong AY, Yung A, Zhang LW, Tse HF, Wu KK, Chan R, Haude M, Mehran R, Mintz GS, Maehara A. Evaluation of Early Healing Profile and Neointimal Transformation Over 24 Months Using Longitudinal Sequential Optical Coherence Tomography Assessments and 3-Year Clinical Results of the New Dual-Therapy Endothelial Progenitor Cell Capturing Sirolimus-Eluting Combo Stent. Circ Cardiovasc Interv 2016; 9:CIRCINTERVENTIONS.115.003469. [DOI: 10.1161/circinterventions.115.003469] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 05/25/2016] [Indexed: 01/24/2023]
Abstract
Background—
Current monotherapy drug-eluting stents are associated with impaired healing, neoatherosclerosis, and late stent thrombosis. The healing profile and neointimal transformation of the first dual-therapy endothelial progenitor cell–capturing sirolimus-eluting stent are unknown.
Methods and Results—
In this prospective, single-center study, 61 patients treated with the Combo stent had optical coherence tomography at baseline, early follow-up (4 monthly groups in a 1:2:2:1 ratio from 2 to 5 months), 9 months, and 24 months. Optical coherence tomography early strut coverage increased from 77.1% to 92.5% to 92.7% to 94.9% between 2 and 5 months. At 9 months, the major adverse cardiac event rate was 1.64%, and angiographic in-stent late loss was 0.24 mm (0.08–0.40). The 36-month major adverse cardiac event rate was 3.3%. From 9 to 24 months, neointimal regression was confirmed by optical coherence tomography: neointimal thickness (median [first quartile and third quartile]), 0.14 mm (0.08 and 0.21) versus 0.12 mm (0.07 and 0.19),
P
<0.001; neointimal volume, 29.9 mm
3
(22.1 and 43.2) versus 26.2 mm
3
(19.6 and 35.8),
P
=0.003; and percent neointimal volume, 17.8% (12.2 and 21.2) versus 15.7% (11.2 and 19.4),
P
=0.01. No definite or probable late stent thrombosis was recorded.
Conclusions—
With additional endothelial progenitor cell–capturing technology, the Combo stent exhibits a unique late neointimal regression (from 9 to 24 months) that has not been reported in any drug-eluting stents, translating into good 36-month clinical results with minimal restenosis and no late stent thrombosis. This is the first study testing the concept of using a longitudinal sequential optical coherence tomography protocol to continuously document early healing profile and late neointimal transformation, predicting long-term outcomes of a new novel stent platform.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifiers: NCT01274234, NCT01756807, and NCT02263313.
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Affiliation(s)
- Stephen W.L. Lee
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Simon C.C. Lam
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Frankie C.C. Tam
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Kelvin K.W. Chan
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Catherine P. Shea
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Shun-Ling Kong
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Anthony Y.T. Wong
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Arthur Yung
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Lei-Wei Zhang
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Hung-Fat Tse
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Karl K.Y. Wu
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Raymond Chan
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Michael Haude
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Roxana Mehran
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Gary S. Mintz
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
| | - Akiko Maehara
- From The University of Hong Kong, Queen Mary Hospital, Hospital Authority (S.W.L.L., S.C.C.L., F.C.C.T., K.K.W.C., C.P.S., S.-L.K., A.Y.T.W., A.Y., L.-W.Z., H.-F.T., K.K.Y.W., R.C.), China; Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany (M.H.); The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY (R.M.); Cardiovascular Research Foundation, New York, NY (R.M., G.S.M., A.M.); and Columbia University Medical Center, New York,
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Optical coherence tomography: A pathway from research to clinical practice. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2016; 17:71-3. [PMID: 26994745 DOI: 10.1016/j.carrev.2016.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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24
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Lee KS, Lee JZ, Hsu CH, Husnain M, Riaz H, Riaz IB, Thai H, Cassese S, Finn A, Samady H, Byrne RA. Temporal Trends in Strut-Level Optical Coherence Tomography Evaluation of Coronary Stent Coverage. Catheter Cardiovasc Interv 2015; 88:1083-1093. [DOI: 10.1002/ccd.26374] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 10/07/2015] [Accepted: 11/22/2015] [Indexed: 11/12/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Salvatore Cassese
- Deutsches Herzzentrum München; Technische Universität München; Munich Germany
| | | | | | - Robert A. Byrne
- Deutsches Herzzentrum München; Technische Universität München; Munich Germany
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25
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Gori T, Jansen T, Weissner M, Foin N, Wenzel P, Schulz E, Cook S, Münzel T. Coronary evaginations and peri-scaffold aneurysms following implantation of bioresorbable scaffolds: incidence, outcome, and optical coherence tomography analysis of possible mechanisms. Eur Heart J 2015; 37:2040-9. [PMID: 26543048 DOI: 10.1093/eurheartj/ehv581] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2015] [Accepted: 08/27/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Peri-stent coronary evaginations may disturb flow and have been proposed as possible risk factor for late stent thrombosis. We describe incidence, predictors, and possible mechanisms of coronary evaginations 12 months after implantation of bioresorbable vascular scaffolds (BVS). METHODS AND RESULTS One hundred and two BVS implanted in 90 patients (age 63 ± 13 years, 71 males, 14 diabetics) were analysed with angiography and optical coherence tomography (OCT) 12 months after implantation. Evaginations were identified as any hollow in the luminal vessel contour between well-apposed struts and were classified as major when extending ≥3 mm with a depth ≥10% of the BVS diameter. Fifty-five (54%) of the BVS (50(56%) of the patients) had at least one evagination (6.1 ± 6.2 evaginations per BVS), with a mean volume of 1.9 ± 1.9 mm(3). Major evaginations were only found in one patient, and in-BVS aneurysms in three patients (4BVS). The presence of evaginations was strongly associated with that of malapposition (P = 0.003) and strut fractures (P = 0.01). No association could be shown between the presence and volume of the evaginations and any clinical variable or the presence of uncovered struts (P > 0.5). Peri-strut low-intensity areas (PSLIA) were present in 29 (53%) of the BVS with evaginations and 12 (26%) of those without (P = 0.0049); their presence was independently associated with the presence, the number (P < 0.003) and volume of the evaginations (P = 0.004) and with that of strut fracture. CONCLUSIONS Optical coherence tomography-detected evaginations are relatively common after BVS implantation, but, as for modern drug-eluting metallic stents, major evaginations are very rare. Optical coherence tomography evidence of immature neointima and strut fractures were associated with more severe development of evaginations.
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Affiliation(s)
- Tommaso Gori
- II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Langenbeckstrasse 1, Mainz 55131 and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Thomas Jansen
- II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Langenbeckstrasse 1, Mainz 55131 and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Melissa Weissner
- II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Langenbeckstrasse 1, Mainz 55131 and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Nicolas Foin
- National Heart Centre Singapore, Singapore, Singapore
| | - Philip Wenzel
- II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Langenbeckstrasse 1, Mainz 55131 and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Eberhard Schulz
- II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Langenbeckstrasse 1, Mainz 55131 and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Stephane Cook
- Hospital and University of Fribourg, Fribourg, Switzerland
| | - Thomas Münzel
- II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Langenbeckstrasse 1, Mainz 55131 and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
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26
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Joner M, Koppara T, Virmani R, Byrne RA. Improving vessel healing with fully bioresorbable drug-eluting stents: more than a pipe dream? Eur Heart J 2015; 37:241-4. [PMID: 26475833 DOI: 10.1093/eurheartj/ehv537] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | - Robert A Byrne
- Deutsches Herzzentrum München, Technische Universitat München, Munich, Germany
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27
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Fu Q, Hu H, Chen W, Tan Z, Li L, Wang D, Chen B. Histological validation of frequency domain optical coherence tomography for the evaluation of neointimal formation after a novel polymer-free sirolimus-eluting stent implantation. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:11068-11075. [PMID: 26617825 PMCID: PMC4637640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Accepted: 08/28/2015] [Indexed: 06/05/2023]
Abstract
Novel polymer-free drug-eluting stents have been developed to reduce polymer-related adverse events. However, neointimal coverage after polymer-free DES implantation is unclear and validation between optical coherence tomography (OCT) and histology is required. Sixteen polymer-free sirolimus-eluting stents were randomly implanted into coronary arteries of 8 normal swine. OCT and histological measurement were conducted at 3 or 6 months after stent placement. For quantitative measures, lumen area, stent area, neointimal area and neointimal thickness were validated in every single OCT and histology matched cross-section. Moreover, for qualitative analysis, OCT signal patterns of neointimal tissue were classified as homogeneous, layered and heterogeneous patterns based on optical intensity and backscatter pattern and peri-strut inflammation was also determined by histology. In total, 70 OCT and histology matched cross-sections were analyzed. At quantitative analysis, good correlations and agreements were found in the measurement of lumen area (ICC = 0.67, P<0.001), neointimal area (ICC = 0.89, P<0.001) and neointimal thickness (ICC = 0.94, P<0.001) except for stent area (ICC 0.19, P = 0.13) between OCT and histology. At qualitative analysis, lymphocyte infiltrations of peri-strut were more frequently seen in heterogeneous sections than in homogeneous sections (10/14 sections, 71.4% vs. 12/50 sections, 24%; P = 0.003). In conclusion, OCT has proper correlation and agreement with histology in assessment of neointimal formation and heterogeneous neointima assessed by OCT may also be associated with peri-strut inflammation detected in histology after polymer-free sirolimus-eluting stents implantation, supporting the use of OCT to evaluate neointimal coverage after polymer-free stent implantation in clinical practice.
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Affiliation(s)
- Qiang Fu
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
| | - Hongyu Hu
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
| | - Wei Chen
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
| | - Zhixu Tan
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
| | - Li Li
- Department of Pathology, National Center for Cardiovascular Disease, China and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing, China
| | - Dezhao Wang
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
| | - Buxing Chen
- Department of Cardiology, Beijing Tiantan Hospital, Capital Medical UniversityBeijing, China
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Nührenberg TG, Zhao M, Stratz C, Amann M, Valina CM, Gick M, Trenk D, Binder H, Büttner HJ, Neumann FJ. Large platelets but not putative endothelial progenitor cells are associated with low strut coverage after drug-eluting stent implantation. Int J Cardiol 2015; 199:358-65. [PMID: 26247791 DOI: 10.1016/j.ijcard.2015.07.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 07/10/2015] [Accepted: 07/20/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study assessed whether different subsets of circulating endothelial and putative endothelial progenitor cells (CEC and EPC) correlate with stent strut coverage (SSC) using second generation optical coherence tomography (OCT). BACKGROUND Due to the lack of imaging modalities with a resolution down to the magnitude of a few cells, the influence of EPC on endothelialisation of drug-eluting stents has not been assessed in patients. METHODS In 37 patients, SSC of everolimus-eluting stents was assessed by OCT 5-7months after stent implantation. Different subsets of EPC (CD34(+)KDR(+), CD34(+)KDR(+)CD45(dim), CD133(+), CD3(+)CD31(+)), CEC (CD31(+)CD45(-)CD146(+)), and CD31(+)CD45(-)CD146(-) representing large platelets were analysed by flow cytometry, including viability analyses with 7-AAD. Statistical analysis comprised univariate regression analysis and multivariable models integrating OCT and flow cytometry data as well as clinical variables. RESULTS SSC and frequency of different cell types were highly comparable with previously published data. EPC defined in part by KDR expression were mostly non-viable. On univariate and in multivariable models, no association between EPC counts and strut coverage was detected. For CD31(+)CD45(-)CD146(-) counts, representing large platelets, an inverse relationship with strut coverage was identified by a multivariable regression model adjusting for age, sex, diabetes mellitus, NYHA and CCS class, CRP, serum triglycerides, glucose and creatinine (beta=-9.42, p=0.006). CONCLUSIONS There was no significant association between EPC or CEC and healing after drug-eluting stent implantation. Yet, CD31(+)CD45(-)CD146(-) cells were associated with low SSC. These data suggest that large platelets may represent a more important mediator of late stent endothelialisation than EPC.
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Affiliation(s)
- Thomas G Nührenberg
- Universitäts-Herzzentrum Freiburg • Bad Krozingen, Klinik für Kardiologie und Angiologie II, Südring 15, D-79189 Bad Krozingen, Germany.
| | - Min Zhao
- Universitäts-Herzzentrum Freiburg • Bad Krozingen, Klinik für Kardiologie und Angiologie II, Südring 15, D-79189 Bad Krozingen, Germany
| | - Christian Stratz
- Universitäts-Herzzentrum Freiburg • Bad Krozingen, Klinik für Kardiologie und Angiologie II, Südring 15, D-79189 Bad Krozingen, Germany
| | - Michael Amann
- Universitäts-Herzzentrum Freiburg • Bad Krozingen, Klinik für Kardiologie und Angiologie II, Südring 15, D-79189 Bad Krozingen, Germany
| | - Christian M Valina
- Universitäts-Herzzentrum Freiburg • Bad Krozingen, Klinik für Kardiologie und Angiologie II, Südring 15, D-79189 Bad Krozingen, Germany
| | - Michael Gick
- Universitäts-Herzzentrum Freiburg • Bad Krozingen, Klinik für Kardiologie und Angiologie II, Südring 15, D-79189 Bad Krozingen, Germany
| | - Dietmar Trenk
- Universitäts-Herzzentrum Freiburg • Bad Krozingen, Klinik für Kardiologie und Angiologie II, Südring 15, D-79189 Bad Krozingen, Germany
| | - Harald Binder
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre Johannes Gutenberg University Mainz, D-55101 Mainz, Germany
| | - Heinz Joachim Büttner
- Universitäts-Herzzentrum Freiburg • Bad Krozingen, Klinik für Kardiologie und Angiologie II, Südring 15, D-79189 Bad Krozingen, Germany
| | - Franz-Josef Neumann
- Universitäts-Herzzentrum Freiburg • Bad Krozingen, Klinik für Kardiologie und Angiologie II, Südring 15, D-79189 Bad Krozingen, Germany
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Karjalainen PP, Nammas W. Excellent very early neointimal coverage of bioactive stents by optical coherence tomography. SCAND CARDIOVASC J 2015; 49:280-5. [DOI: 10.3109/14017431.2015.1071495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Wail Nammas
- Heart Center, Satakunta Central Hospital, Pori, Finland
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Silva GV, Gahremanpour A, Attizzani GF, Zeng Y, Wang W, Yamamoto H, Kanaya T, Rippy MK, Bezerra HG, Costa MA, Perin E. Comparison of scanning electron microscopy and optical coherence tomography for imaging of coronary bifurcation stents. Catheter Cardiovasc Interv 2015; 85:1141-9. [DOI: 10.1002/ccd.25612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 07/14/2014] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | - Yi Zeng
- Texas Heart Institute; Houston Texas
| | - Wei Wang
- Harrington Heart and Vascular Institute, Case Medical Center; Cleveland Ohio
| | - Hirosada Yamamoto
- Harrington Heart and Vascular Institute, Case Medical Center; Cleveland Ohio
| | - Tomoaki Kanaya
- Harrington Heart and Vascular Institute, Case Medical Center; Cleveland Ohio
| | | | - Hiram G. Bezerra
- Harrington Heart and Vascular Institute, Case Medical Center; Cleveland Ohio
| | - Marco A. Costa
- Harrington Heart and Vascular Institute, Case Medical Center; Cleveland Ohio
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Zivelonghi C, Ghione M, Kilickesmez K, Loureiro RE, Foin N, Lindsay A, de Silva R, Ribichini F, Vassanelli C, Di Mario C. Intracoronary optical coherence tomography: a review of clinical applications. J Cardiovasc Med (Hagerstown) 2015; 15:543-53. [PMID: 24922045 DOI: 10.2459/jcm.0000000000000032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Optical coherence tomography (OCT) is a light-based technology that provides very high spatial resolution images. OCT has been initially employed as a research tool to investigate plaque morphology and stent strut coverage. The introduction of frequency domain OCT allowing fast image acquisition during a prolonged contrast injection via the guiding catheter has made OCT applicable for guidance of coronary interventions. In this manuscript, the various applications of OCT are reviewed, from assessment of plaque vulnerability and severity to characteristics of unstable lesions and thrombus burden to stent optimization and evaluation of late results.
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Affiliation(s)
- Carlo Zivelonghi
- aCardiovascular Biomedical Research Unit, Royal Brompton Hospital bImperial College, London, UK cDepartment of Medicine, University of Verona, Verona, Italy
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Walters DL, Christopher Raffel O, Jang IK. Are the findings of optical coherence tomography sufficient for the evaluation of the safety and efficacy of the next generation of drug eluting stents? Int J Cardiol 2015; 179:127-8. [PMID: 25464431 DOI: 10.1016/j.ijcard.2014.10.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 10/20/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Darren L Walters
- The Prince Charles Hospital, Rode Rd, Brisbane, Australia; The University of Queensland, St Lucia, Brisbane, Australia.
| | - O Christopher Raffel
- The Prince Charles Hospital, Rode Rd, Brisbane, Australia; The University of Queensland, St Lucia, Brisbane, Australia
| | - Ik-Kyung Jang
- Massachusetts General Hospital, 55 Fruit St, Boston, United States; Harvard Medical School Boston, United States
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Neointimal coverage of zotarolimus-eluting stent at 1, 2, and 3 months’ follow-up: an optical coherence tomography study. Heart Vessels 2014; 31:206-11. [DOI: 10.1007/s00380-014-0598-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 10/17/2014] [Indexed: 10/24/2022]
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Kobayashi M, Haraguchi Y, Shimizu T, Mizuuchi K, Iseki H. Real-time, noninvasive optical coherence tomography of cross-sectional living cell-sheets in vitro and in vivo. J Biomed Mater Res B Appl Biomater 2014; 103:1267-73. [PMID: 25350859 DOI: 10.1002/jbm.b.33309] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Revised: 09/23/2014] [Accepted: 10/01/2014] [Indexed: 12/13/2022]
Abstract
Cell sheet technology has a history of application in regenerating various tissues, having successfully completed several clinical trials using autologous cell sheets. Tomographic analysis of living cell sheets is an important tool in the field of cell sheet-based regenerative medicine and tissue engineering to analyze the inner structure of layered living cells. Optical coherence tomography (OCT) is commonly used in ophthalmology to noninvasively analyze cross-sections of target tissues at high resolution. This study used OCT to conduct real-time, noninvasive analysis of living cell sheet cross sections. OCT showed the internal structure of cell sheets in tomographic images synthesized with backscatter signals from inside the living cell sheet without invasion or damage. OCT observations were used to analyze the static and dynamic behaviors of living cell sheets in vitro and in vivo including (1) the harvesting process of a C2C12 mouse skeletal myoblast sheet from a temperature-responsive culture surface; (2) cell-sheet adhesion onto various surfaces including a culture surface, a synthetic rubber glove, and the dorsal subcutaneous tissue of rats; and (3) the real-time propagation of beating rat cardiac cells within cardiac cell sheets. This study showed that OCT technology is a powerful tool in the field of cell sheet-based regenerative medicine and tissue engineering.
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Affiliation(s)
- Mari Kobayashi
- Joint Graduate School of Tokyo Women's Medical University and Waseda University, Shinjuku-ku, Tokyo, 162-8666, Japan.,Panasonic Healthcare, Nishi-shinbashi MF Bldg, Minato-ku, Tokyo, 105-8433, Japan
| | - Yuji Haraguchi
- Institute of Advanced Biomedical Engineering and Science, TWIns, Tokyo Women's Medical University, Tokyo, 162-8666, Japan
| | - Tatsuya Shimizu
- Institute of Advanced Biomedical Engineering and Science, TWIns, Tokyo Women's Medical University, Tokyo, 162-8666, Japan
| | - Kiminori Mizuuchi
- Panasonic Healthcare, Nishi-shinbashi MF Bldg, Minato-ku, Tokyo, 105-8433, Japan
| | - Hiroshi Iseki
- Joint Graduate School of Tokyo Women's Medical University and Waseda University, Shinjuku-ku, Tokyo, 162-8666, Japan.,Institute of Advanced Biomedical Engineering and Science, TWIns, Tokyo Women's Medical University, Tokyo, 162-8666, Japan
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Stent implantation and optical frequency domain imaging with carbon dioxide for chronic total occlusion in the superficial femoral artery. Cardiovasc Interv Ther 2014; 30:362-6. [PMID: 25319810 DOI: 10.1007/s12928-014-0303-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Abstract
A 68-year-old female was presented with claudication in the left lower leg. She underwent angiography with carbon dioxide (CO2) because she had a history of anaphylactic shock to iodinated contrast medium. It revealed total occlusion of the left superficial femoral artery (SFA), and subsequently endovascular therapy (EVT) was performed by an antegrade approach from the left common femoral artery. After stent implantation, we performed optical frequency domain imaging (OFDI) using CO2 as contrast medium. OFDI has been extensively studied in the coronary circulation; however, its use in the peripheral arterial circulation is scarce. We present a case of stent implantation and OFDI using CO2 as an ancillary tool during EVT for SFA lesions in the patient with contraindication to iodinated contrast medium.
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Vignali L, Solinas E, Emanuele E. Research and clinical applications of optical coherence tomography in invasive cardiology: a review. Curr Cardiol Rev 2014; 10:369-76. [PMID: 24893934 PMCID: PMC4101202 DOI: 10.2174/1573403x10666140604120753] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 05/29/2014] [Accepted: 06/01/2014] [Indexed: 11/22/2022] Open
Abstract
In cardiology, optical coherence tomography (OCT) is an invasive imaging technique based on the principle of light coherence. This system was developed to obtain three-dimensional high resolution images to examine coronary artery normal and/or pathological structure. This technique replaces the ultrasound used by its main alternative procedure, intravascular ultrasound, by a near-infrared light source. Acute coronary syndromes due to atherosclerotic vascular disease are the leading cause of mortality in developed and developing countries. As a consequence, intravascular imaging systems became an important area of research and 1991 marks the first use of OCT in coronary artery observations. Since its first appearance in invasive cardiology, OCT maintains a strong presence in the research environments for the identification of vulnerable plaques, as it is able to overcome difficulties presented by other techniques such as virtual intravascular ultrasound, near-infrared spectroscopy, and histology. Moreover, OCT is increasingly being used in the clinical practice as a guide during coronary interventions and in the assessment of vascular response after coronary stent implantation. This review focuses on the relevance of OCT in research and clinical applications in the field of invasive cardiology and discusses the future directions of the field.
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Affiliation(s)
| | | | - Enzo Emanuele
- Living Research s.a.s., Via Monte Grappa, 13, I-27038, Robbio (PV), Italy.
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Intracoronary Optical Coherence Tomography: Insights from Clinical Research—What Do We Need to Learn? CURRENT CARDIOVASCULAR IMAGING REPORTS 2014. [DOI: 10.1007/s12410-014-9286-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Does optical coherence tomography optimize results of stenting? Rationale and study design. Am Heart J 2014; 168:175-81.e1-2. [PMID: 25066556 DOI: 10.1016/j.ahj.2014.05.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 05/14/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND To date, no randomized study has investigated the value of optical coherence tomography (OCT) in optimizing the results of coronary angioplasty for non-ST-segment elevation acute coronary syndromes. METHODS DOCTORS is a randomized, prospective, multicenter, open-label clinical trial to evaluate the utility of OCT to optimize results of angioplasty of a lesion responsible for non-ST-elevation acute coronary syndromes. Patients (n = 250) will be randomized to undergo OCT-guided angioplasty (use of OCT to optimize procedural result, including change to strategy with the possibility of additional interventions) or angioplasty under fluoroscopy alone. The primary end point is the functional result of the angioplasty procedure as assessed by fractional flow reserve (FFR) measured at the end of the procedure. Secondary end points include safety of OCT in the context of angioplasty for ACS, percentage of patients in whom OCT reveals suboptimal result of stenting, percentage of patients in whom a change in procedural strategy is decided based on OCT data, correlation between quantitative measures by OCT and FFR, determination of a threshold for quantitative OCT measure that best predicts FFR ≥ 0.90, and identification of OCT variables that predict postprocedure FFR. Adverse cardiac events (death, recurrent myocardial infarction, stent thrombosis, and repeat target lesion revascularization) at 6 months will be recorded. CONCLUSION The DOCTORS randomized trial (ClinicalTrials.gov NCT01743274) is designed to investigate whether use of OCT yields useful additional information beyond that obtained by angiography alone and, if so, whether this information changes physician strategy and impacts on the functional result of angioplasty as assessed by FFR.
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Foin N, Gutiérrez-Chico JL, Nakatani S, Torii R, Bourantas CV, Sen S, Nijjer S, Petraco R, Kousera C, Ghione M, Onuma Y, Garcia-Garcia HM, Francis DP, Wong P, Di Mario C, Davies JE, Serruys PW. Incomplete Stent Apposition Causes High Shear Flow Disturbances and Delay in Neointimal Coverage as a Function of Strut to Wall Detachment Distance. Circ Cardiovasc Interv 2014; 7:180-9. [DOI: 10.1161/circinterventions.113.000931] [Citation(s) in RCA: 163] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Nicolas Foin
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Juan Luis Gutiérrez-Chico
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Shimpei Nakatani
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Ryo Torii
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Christos V. Bourantas
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Sayan Sen
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Sukhjinder Nijjer
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Ricardo Petraco
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Chrysa Kousera
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Matteo Ghione
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Yoshinobu Onuma
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Hector M. Garcia-Garcia
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Darrel P. Francis
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Philip Wong
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Carlo Di Mario
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Justin E. Davies
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
| | - Patrick W. Serruys
- From the International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom (N.F., S.S., S.N., R.P., C.K., D.P.F., J.E.D., P.W.S.); National Heart Centre Singapore, Singapore (N.F., P.W.); ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands (J.L.G.-C., S.N., C.V.B., Y.O., H.M.G.-G., P.W.S.); Ludwig-Maximilian Universität, München, Germany (J.L.G.-C.); Department of Mechanical Engineering, University College London, London, United Kingdom (R.T.); NIHR, BRU
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Attizzani GF, Capodanno D, Ohno Y, Tamburino C. Mechanisms, pathophysiology, and clinical aspects of incomplete stent apposition. J Am Coll Cardiol 2014; 63:1355-67. [PMID: 24530675 DOI: 10.1016/j.jacc.2014.01.019] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 12/12/2013] [Accepted: 01/07/2014] [Indexed: 11/25/2022]
Abstract
Incomplete stent apposition (ISA) is characterized by the lack of contact of at least 1 stent strut with the vessel wall in a segment not overlying a side branch; it is more commonly found in drug-eluting stents than bare-metal stents. The accurate diagnosis of ISA, initially only possible with intravascular ultrasound, can currently be performed with higher accuracy by optical coherence tomography, which also enables strut-level assessment due to its higher axial resolution. Different circumstances related both to the index procedure and to vascular healing might influence ISA occurrence. Although several histopathology and clinical studies linked ISA to stent thrombosis, potential selection bias precluded definitive conclusions. Initial studies usually performed single time point assessments comparing overall ISA percentage and magnitude in different groups (i.e., stent type), thus hampering a comprehensive understanding of its relationship with vascular healing. Serial intravascular imaging studies that evaluated vascular response heterogeneity recently helped fill this gap. Some particular clinical scenarios such as acute coronary syndromes, bifurcations, tapered vessels, overlapping stents, and chronic total occlusions might predispose to ISA. Interventional cardiologists should be committed to optimal stent choices and techniques of implantation and use intravascular imaging guidance when appropriate to aim at minimizing acute ISA. In addition, the active search for new stent platforms that could accommodate vessel remodeling over time (i.e., self-expandable stents) and for new polymers and/or eluting drugs that could induce less inflammation (hence, less positive remodeling) could ultimately reduce the occurrence of ISA and its potentially harmful consequences.
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Affiliation(s)
- Guilherme F Attizzani
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; Division of Interventional Cardiology, Pitangueiras Hospital, Jundiaí, SP, Brazil; Harrington Heart and Vascular Institute, University Hospitals, Case Medical Center, Cleveland, Ohio
| | - Davide Capodanno
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; Excellence Through Newest Advances (ETNA) Foundation, Catania, Italy.
| | - Yohei Ohno
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy
| | - Corrado Tamburino
- Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy; Excellence Through Newest Advances (ETNA) Foundation, Catania, Italy
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Nammas W, Ligthart JMR, Karanasos A, Witberg KT, Regar E. Optical coherence tomography for evaluation of coronary stentsin vivo. Expert Rev Cardiovasc Ther 2014; 11:577-88. [DOI: 10.1586/erc.13.37] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Nakatani S, Onuma Y, Ishibashi Y, Eggermont J, Zhang YJ, Campos CM, Cho YK, Liu S, Dijkstra J, Reiber JH, Perkins L, Sheehy A, Veldhof S, Rapoza R, van Es GA, Garcia-Garcia HM, van Geuns RJ, Serruys PW. Temporal Evolution of Strut Light Intensity After Implantation of Bioresorbable Polymeric Intracoronary Scaffolds in the ABSORB Cohort B Trial. Circ J 2014; 78:1873-81. [DOI: 10.1253/circj.cj-14-0143] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Inoue T, Shinke T, Otake H, Nakagawa M, Hariki H, Osue T, Iwasaki M, Taniguchi Y, Nishio R, Hiranuma N, Konishi A, Kinutani H, Shite J, Hirata KI. Neoatherosclerosis and Mural Thrombus Detection After Sirolimus-Eluting Stent Implantation. Circ J 2014; 78:92-100. [DOI: 10.1253/circj.cj-13-0374] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Takumi Inoue
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Toshiro Shinke
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hiromasa Otake
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Masayuki Nakagawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hirotoshi Hariki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Tsuyoshi Osue
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Masamichi Iwasaki
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Yu Taniguchi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Ryo Nishio
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Noritoshi Hiranuma
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Akihide Konishi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Hiroto Kinutani
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Junya Shite
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
| | - Ken-ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine
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Natural history of low-intensity neointimal tissue after an everolimus-eluting stent implantation: a serial observation with optical coherence tomography. Heart Vessels 2013; 30:136-9. [PMID: 24374577 DOI: 10.1007/s00380-013-0450-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 11/15/2013] [Indexed: 10/25/2022]
Abstract
Although previous optical coherence tomography (OCT) studies reported that restenosis tissue after implantation of a drug-eluting stent (DES) was composed of a variety of cells, the clinical significance of morphologic characteristics for in-stent neointimal tissue as assessed by OCT has not been clarified. We experienced a patient with stable angina who underwent percutaneous coronary intervention with a 2.5 × 18-mm DES implantation 6 months before the OCT examination. OCT imaging showed a mild intimal hyperplasia (39 % neointimal hyperplasia) with eccentric, heterogeneous tissue, predominantly of low signal intensity. Seventeen months after the initial procedure, OCT revealed a significant increase in percent neointimal hyperplasia of 58 %, with morphologically different intimal tissue of concentric homogeneous high intensity in the stented segments. This finding suggests that low-intensity intimal tissue morphology detected by OCT could be a morphometric predictor of late neointimal tissue growth after DES implantation.
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Optical coherence tomography and histopathological assessment of delayed arterial healing after drug-eluting stent implant in a pig coronary model. Int J Cardiol 2013; 170:152-9. [DOI: 10.1016/j.ijcard.2013.10.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 09/15/2013] [Accepted: 10/07/2013] [Indexed: 11/19/2022]
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Attizzani GF, Bezerra HG, Ormiston J, Wang W, Donohoe D, Wijns W, Costa MA. Serial assessment by optical coherence tomography of early and late vascular responses after implantation of an absorbable-coating Sirolimus-Eluting stent (from the first-in-human DESSOLVE I trial). Am J Cardiol 2013; 112:1557-64. [PMID: 23992957 DOI: 10.1016/j.amjcard.2013.07.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 07/12/2013] [Accepted: 07/12/2013] [Indexed: 10/26/2022]
Abstract
The initial enthusiasm caused by the potent antirestenotic effect of early generation drug-eluting stents was recently plagued by concerns regarding their safety profile. Investigators worldwide were stimulated, therefore, to seek for improvement in drug-eluting stent technology, such as eliminating their permanent polymer blamed for vascular inflammation and delayed healing. Optical coherence tomography (OCT) assessments of stent-vessel interactions are used as a surrogate for vessel healing after DES implantation. Herewith, we report serial OCT assessments of vascular reactions to the implantation of a novel absorbable polymer sirolimus-eluting stent (MiStent). In total, 30 patients were included. At 4-, 6-, and 8-month follow-up, different groups of 10 patients underwent OCT imaging, whereas all the patients had OCT assessments scheduled at 18-month follow-up. A total of 13,569 stent struts were analyzed. Low rates of uncovered (14.34 ± 15.35%, 6.62 ± 10.93%, 3.51 ± 2.87%, and 0.84 ± 1.15%, respectively, p <0.05 for 8- vs 18-month follow-up) and malapposed (3.74 ± 7.35%, 3.15 ± 6.13%, 0.48 ± 0.56%, and 0.09 ± 0.28%, respectively, p = NS) stent struts coupled with thin and increasingly homogenous neointimal proliferation were demonstrated. Neointimal area increased from 4- to 8-month follow-up (0.46 ± 0.29 and 1.12 ± 0.73 mm(2), respectively, p <0.05), whereas no "late catch up" was demonstrated at 18-month follow-up (1.28 ± 0.66 mm(2), p = NS vs 8-month follow-up). Early tissue maturation and reduction of low signal intensity tissue covering stent struts (8.8%, 3.1%, 0.3%, and 0%, respectively, p <0.05 for 4- vs 8-month follow-up comparison) were revealed by optical density analysis. In addition, high rates of strut coverage overlying the ostia of side branches without proliferative pattern were demonstrated. In conclusion, this comprehensive OCT analysis depicted favorable absorbable polymer sirolimus-eluting stent-vessel interactions up to 18-month follow-up.
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Ghione M, Kýlýçkesmez K, Zivelonghi C, Estevez Loureiro R, Foin N, Mattesini A, Secco GG, Dall’Ara G, Rama-Merchan JC, de Silva R, Di Mario C. Intracoronary Optical Coherence Tomography: Experience and Indications for Clinical Use. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013. [DOI: 10.1007/s12410-013-9219-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Stabile E, Ambrosini V, Squarcia R, Salemme L, Popusoi G, Esposito G, Trimarco B, Rubino P. Percutaneous sympathectomy of the renal arteries: the OneShot™ Renal Denervation System is not associated with significant vessel wall injury. EUROINTERVENTION 2013; 9:694-9. [DOI: 10.4244/eijv9i6a113] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kim JS, Afari ME, Ha J, Tellez A, Milewski K, Conditt G, Cheng Y, Hua Yi G, Kaluza GL, Granada JF. Neointimal patterns obtained by optical coherence tomography correlate with specific histological components and neointimal proliferation in a swine model of restenosis. Eur Heart J Cardiovasc Imaging 2013; 15:292-8. [DOI: 10.1093/ehjci/jet162] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gutiérrez-Chico JL, Räber L, Regar E, Okamura T, di Mario C, van Es GA, Windecker S, Serruys PW. Tissue coverage and neointimal hyperplasia in overlap versus nonoverlap segments of drug-eluting stents 9 to 13 months after implantation: in vivo assessment with optical coherence tomography. Am Heart J 2013; 166:83-94. [PMID: 23816026 DOI: 10.1016/j.ahj.2013.04.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 04/01/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Histologic experimental studies have reported incomplete neointimal healing in overlapping with respect to nonoverlapping segments in drug-eluting stents (DESs), but these observations have not been confirmed in human coronary arteries hitherto. On the contrary, angiographic and optical coherence tomography studies suggest that DES overlap elicits rather an exaggerated than an incomplete neointimal reaction. METHODS Optical coherence tomography studies from 2 randomized trials including sirolimus-eluting, biolimus-eluting, everolimus-eluting, and zotarolimus-eluting stents were analyzed at 9- to 13-month follow-up. Coverage in overlapping segments was compared versus the corresponding nonoverlapping segments of the same stents, using statistical pooled analysis. RESULTS Forty-two overlaps were found in 31 patients: 11 in sirolimus-eluting stents, 3 in biolimus-eluting stents, 17 in everolimus-eluting stents, and 11 in zotarolimus-eluting stents. The risk ratio of incomplete coverage was 2.35 (95% CI 1.86-2.98) in overlapping versus nonoverlapping segments. Thickness of coverage in overlaps was only 85% (95% CI 81%-90%) of the thickness in nonoverlaps. Significant heterogeneity of the effect was observed, especially pronounced in the comparison of thickness of coverage (I(2) = 90.31). CONCLUSIONS The effect of overlapping DES on neointimal inhibition is markedly heterogeneous: on average, DES overlap is associated with more incomplete and thinner coverage, but in some cases, the overlap elicits an exaggerated neointimal reaction, thicker than in the corresponding nonoverlapping segments. These results might help to understand why overlapping DES is associated with worse clinical outcomes, both in terms of thrombotic phenomena and in terms of restenosis and revascularization.
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