1
|
Shafiabadi Hassani N, Ogliari LC, Vieira de Oliveira Salerno PR, Pereira GTR, Ribeiro MH, Palma Dallan LA. In-Stent Restenosis Overview: From Intravascular Imaging to Optimal Percutaneous Coronary Intervention Management. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:549. [PMID: 38674195 PMCID: PMC11051745 DOI: 10.3390/medicina60040549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
Despite ongoing progress in stent technology and deployment techniques, in-stent restenosis (ISR) still remains a major issue following percutaneous coronary intervention (PCI) and accounts for 10.6% of all interventions in the United States. With the continuous rise in ISR risk factors such as obesity and diabetes, along with an increase in the treatment of complex lesions with high-risk percutaneous coronary intervention (CHIP), a substantial growth in ISR burden is expected. This review aims to provide insight into the mechanisms, classification, and management of ISR, with a focus on exploring innovative approaches to tackle this complication comprehensively, along with a special section addressing the approach to complex calcified lesions.
Collapse
Affiliation(s)
- Neda Shafiabadi Hassani
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA; (N.S.H.); (P.R.V.d.O.S.); (G.T.R.P.)
- Intravascular Imaging Core Laboratory, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Lucas Carlini Ogliari
- SOS Cardio Hospital and Imperial Hospital de Caridade, Florianópolis 88020-210, SC, Brazil; (L.C.O.); (M.H.R.)
| | - Pedro Rafael Vieira de Oliveira Salerno
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA; (N.S.H.); (P.R.V.d.O.S.); (G.T.R.P.)
- Intravascular Imaging Core Laboratory, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Gabriel Tensol Rodrigues Pereira
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA; (N.S.H.); (P.R.V.d.O.S.); (G.T.R.P.)
- Intravascular Imaging Core Laboratory, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Marcelo Harada Ribeiro
- SOS Cardio Hospital and Imperial Hospital de Caridade, Florianópolis 88020-210, SC, Brazil; (L.C.O.); (M.H.R.)
| | - Luis Augusto Palma Dallan
- Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA; (N.S.H.); (P.R.V.d.O.S.); (G.T.R.P.)
| |
Collapse
|
2
|
Wang H, Wang Q, Hu J, Zhang R, Gao T, Rong S, Dong H. Global research trends in in-stent neoatherosclerosis: A CiteSpace-based visual analysis. Front Cardiovasc Med 2022; 9:1025858. [PMID: 36426225 PMCID: PMC9679497 DOI: 10.3389/fcvm.2022.1025858] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/25/2022] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Recent studies have shown that in-stent neoatherosclerosis (ISNA/NA) is an important cause of late stent failure. A comprehensive understanding of the current state of research in this field will facilitate the analysis of its development trends and hot frontiers. However, no bibliometric correlation has been reported yet. Here, we analyze the relevant literature since the emergence of the concept and provide valuable insights. METHODS Publications were collected from the Web of Science Core Collection (WoSCC) and PubMed. Microsoft Excel, SPSS and CiteSpace were used to analyze and present the data. RESULTS A total of 498 articles were collected, with Japan and Cardiovasc Res Fdn being the main publishing forces in all country/region and institutions. J AM COLL CARDIOL is the journal with the most published and co-cited articles. According to co-citation analysis, optical coherence tomography, thrombosis, implantation, restenosis, drug-eluting stent, and bare metal stent have become more and more popular recently. CONCLUSION ISNA is a niche and emerging field. How to reduce the incidence of ISNA and improve the late patency rate of coronary stents may remain a hot spot for future research. The pathogenesis of ISNA also needs to be explored in more depth.
Collapse
Affiliation(s)
- Heng Wang
- Department of Vascular Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Qian Wang
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jie Hu
- Department of Vascular Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Ruijing Zhang
- Department of Nephrology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Tingting Gao
- Department of Vascular Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Shuling Rong
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Honglin Dong
- Department of Vascular Surgery, The Second Hospital of Shanxi Medical University, Taiyuan, China
| |
Collapse
|
3
|
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
|
4
|
Abstract
In-stent restenosis (ISR) remains the most common cause of stent failure after percutaneous coronary intervention (PCI). Recent data suggest that ISR-PCI accounts for 5-10% of all PCI procedures performed in current clinical practice. This State-of-the-Art review will primarily focus on the management of ISR but will begin by briefly discussing diagnosis and classification. We then move on to detail the evidence base underpinning the various therapeutic strategies for ISR before finishing with a proposed ISR management algorithm based on current scientific data.
Collapse
Affiliation(s)
- Fernando Alfonso
- Department of Cardiology, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, IIS-IP, CIBER-CV, Calle de Diego de León 62, 28006 Madrid, Spain
| | - J. J. Coughlan
- Deutsches Herzzentrum München und Technische Universität München, Munich, Germany,Department of Cardiology, ISAResearch, German Heart Center, Munich, Germany,Cardiovascular Research Institute, Mater Private Network, Dublin, Ireland,School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Daniele Giacoppo
- Department of Cardiology, ISAResearch, German Heart Center, Munich, Germany,Cardiovascular Research Institute, Mater Private Network, Dublin, Ireland,School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland,Department of Cardiology, Alto Vicentino Hospital, Santorso, Italy
| | - Adnan Kastrati
- Deutsches Herzzentrum München und Technische Universität München, Munich, Germany,Department of Cardiology, ISAResearch, German Heart Center, Munich, Germany,German Center for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany
| | - Robert A. Byrne
- Cardiovascular Research Institute, Mater Private Network, Dublin, Ireland,School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| |
Collapse
|
5
|
Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS, Nnacheta LC, Rao SV, Sellke FW, Sharma G, Yong CM, Zwischenberger BA. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2021; 145:e18-e114. [PMID: 34882435 DOI: 10.1161/cir.0000000000001038] [Citation(s) in RCA: 139] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIM The guideline for coronary artery revascularization replaces the 2011 coronary artery bypass graft surgery and the 2011 and 2015 percutaneous coronary intervention guidelines, providing a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization as well as the supporting documentation to encourage their use. METHODS A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. Structure: Coronary artery disease remains a leading cause of morbidity and mortality globally. Coronary revascularization is an important therapeutic option when managing patients with coronary artery disease. The 2021 coronary artery revascularization guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with coronary artery disease who are being considered for coronary revascularization, with the intent to improve quality of care and align with patients' interests.
Collapse
|
6
|
Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS, Nnacheta LC, Rao SV, Sellke FW, Sharma G, Yong CM, Zwischenberger BA. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol 2021; 79:e21-e129. [PMID: 34895950 DOI: 10.1016/j.jacc.2021.09.006] [Citation(s) in RCA: 535] [Impact Index Per Article: 178.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
AIM The guideline for coronary artery revascularization replaces the 2011 coronary artery bypass graft surgery and the 2011 and 2015 percutaneous coronary intervention guidelines, providing a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization as well as the supporting documentation to encourage their use. METHODS A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. STRUCTURE Coronary artery disease remains a leading cause of morbidity and mortality globally. Coronary revascularization is an important therapeutic option when managing patients with coronary artery disease. The 2021 coronary artery revascularization guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with coronary artery disease who are being considered for coronary revascularization, with the intent to improve quality of care and align with patients' interests.
Collapse
|
7
|
Rai H, Alfonso F, Maeng M, Bradaric C, Wiebe J, Cuesta J, Christiansen EH, Cassese S, Hoppmann P, Colleran R, Harzer F, Bresha J, Nano N, Schneider S, Laugwitz KL, Joner M, Kastrati A, Byrne RA. Optical coherence tomography tissue coverage and characterization at six months after implantation of bioresorbable scaffolds versus conventional everolimus eluting stents in the ISAR-Absorb MI trial. Int J Cardiovasc Imaging 2021; 37:2815-2826. [PMID: 34420177 PMCID: PMC8494721 DOI: 10.1007/s10554-021-02251-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 04/16/2021] [Indexed: 11/28/2022]
Abstract
Purpose Data regarding vessel healing by optical coherence tomography (OCT) after everolimus-eluting bioresorbable scaffolds (BRS) or everolimus-eluting metallic stent (EES) implantation in acute myocardial infarction (AMI) patients is scarce. We compared OCT findings after BRS or EES implantation in patients with AMI enrolled in a randomized trial. Methods In ISAR-Absorb MI, AMI patients were randomized to BRS or EES implantation, with 6–8 month angiographic follow-up. This analysis includes patients who underwent OCT during surveillance angiography. Tissue characterization was done using grey-scale signal intensity analysis. The association between OCT findings and target lesion failure (TLF) at 2 years was investigated. Results OCT was analyzed in 103 patients (2237 frames, 19,827 struts) at a median of 216 days post-implantation. Of these, 70 were treated with BRS versus 32 with EES. Pre-(92.8 vs. 68.7%, p = 0.002) and post-dilation (51.4 vs. 12.5%, p < 0.001) were more common in BRS as compared to EES. Strut coverage was higher in BRS vs. EES (97.5% vs. 90.9%, p < 0.001). Mean neointimal thickness was comparable in both groups [85.5 (61.9, 124.1) vs. 69.5 (32.7, 127.5) µm, respectively, p = 0.20]. Mature neointimal regions were numerically more common in BRS (43.0% vs. 24.6%; p = 0.35); this difference was statistically significant in ST-elevation myocardial infarction patients (40.9% vs. 21.1%, p = 0.03). At two-years, 8 (7.8%) patients experienced TLF. Mean neointimal area [0.61 (0.21, 1.33) vs. 0.41 (0.11, 0.75) mm2, p = 0.03] and mean neointimal coverage [106.1 (65.2, 214.8) vs. 80.5 (53.5, 122.1) µm, p < 0.01] were higher, with comparable tissue maturity, in lesions with versus without TLF. Conclusions In selected patients who underwent OCT surveillance 6–8 months after coronary intervention for AMI with differing implantation characteristics depending on the device type used, vessel healing was more advanced in BRS compared with EES, particularly in the STEMI subgroup. Supplementary Information The online version contains supplementary material available at 10.1007/s10554-021-02251-x.
Collapse
Affiliation(s)
- Himanshu Rai
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Cardiovascular Research Institute Dublin, Mater Private Network, Dublin, Ireland.,School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | - Christian Bradaric
- Medizinische Klinik Und Poliklinik Innere Medizin I, Klinikum Rechts Der Isar, Technische Universität München, Munich, Germany
| | - Jens Wiebe
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Javier Cuesta
- Hospital Universitario de La Princesa Madrid, Madrid, Spain
| | | | - Salvatore Cassese
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Petra Hoppmann
- Medizinische Klinik Und Poliklinik Innere Medizin I, Klinikum Rechts Der Isar, Technische Universität München, Munich, Germany
| | - Roisin Colleran
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Cardiovascular Research Institute Dublin, Mater Private Network, Dublin, Ireland.,School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Fiona Harzer
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Jola Bresha
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Nejva Nano
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Simon Schneider
- Medizinische Klinik Und Poliklinik Innere Medizin I, Klinikum Rechts Der Isar, Technische Universität München, Munich, Germany
| | - Karl-Ludwig Laugwitz
- Medizinische Klinik Und Poliklinik Innere Medizin I, Klinikum Rechts Der Isar, Technische Universität München, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Michael Joner
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Adnan Kastrati
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Robert A Byrne
- Cardiovascular Research Institute Dublin, Mater Private Network, Dublin, Ireland. .,School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
| |
Collapse
|
8
|
Ijichi T, Nakazawa G, Torii S, Nagamatsu H, Yoshikawa A, Nakamura S, Souba J, Isobe A, Hagiwara H, Ikari Y. Late neointimal volume reduction is observed following biodegradable polymer-based drug eluting stent in porcine model. IJC HEART & VASCULATURE 2021; 34:100792. [PMID: 34036146 PMCID: PMC8134975 DOI: 10.1016/j.ijcha.2021.100792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND The BP-SES has an abluminally applied biodegradable polymer that is fully resorbed after 3-4 months but may have longer-lasting effects. The aim of this study was to determine the long-term vascular response to the novel Ultimaster™ sirolimus-eluting stent (BP-SES). METHODS BP-SESs, everolimus-eluting stents (DP-EESs), and bare metal stents were implanted in 22 coronary arteries of 15 mini-swine. All animals underwent optical frequent domain imaging (OFDI) to assess neointimal volume and quality at either 1 (n = 7) or 3 (n = 8) months and at 9 (n = 15) months and were euthanized at 9 months. Stents were subsequently histologically investigated to analyze the vascular response and maturity of neointimal tissue according to cell density. RESULTS OFDI revealed greater regression in neointimal volume from 3 to 9 months with BP-SESs than with DP-EESs (-0.6 ± 0.5 mm2 vs. 0.00 ± 0.4 mm2, p = 0.07). Although there was no significant difference between BP-SESs and DP-EESs in the inflammation score (BMS, BP-SES, and DP-EES: 0.1 ± 0.1, 0.3 ± 0.4, and 0.4 ± 0.4, respectively; p < 0.0001) in histological analysis, BP-SESs showed slightly greater maturity than DP-EESs (1.8 ± 0.3, 1.7 ± 0.3, and 1.6 ± 0.3, p = 0.09). CONCLUSIONS While both BP-SESs and DP-EESs showed minimal inflammatory responses at 9 months, BP-SESs showed a trend for greater neointimal maturity and regression, which may be related to earlier completion of the vascular response.
Collapse
Affiliation(s)
- Takeshi Ijichi
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | - Gaku Nakazawa
- Department of Cardiology, Kindai University, Faculty of Medicine, Osaka, Japan
| | - Sho Torii
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | - Ayako Yoshikawa
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| | | | - Junko Souba
- TERUMO Corporation Evaluation Center, Kanagawa, Japan
| | - Atsushi Isobe
- TERUMO Corporation Evaluation Center, Kanagawa, Japan
| | | | - Yuji Ikari
- Department of Cardiology, Tokai University, School of Medicine, Kanagawa, Japan
| |
Collapse
|
9
|
Tsujimura T, Ishihara T, Iida O, Hata Y, Toyoshima T, Higashino N, Kurata N, Asai M, Masuda M, Okamoto S, Nanto K, Kanda T, Matsuda Y, Mano T. Arterial Healing 10 Months After Implantation of an Ultrathin-Strut, Biodegradable-Polymer, Sirolimus-Eluting Stent - An Angioscopic Study. Circ Rep 2021; 3:316-323. [PMID: 34136706 PMCID: PMC8180372 DOI: 10.1253/circrep.cr-21-0053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background:
The OrsiroTM
ultrathin-strut, biodegradable-polymer, sirolimus-eluting stent (O-SES) has specific characteristics regarding its components and has demonstrated comparable clinical outcomes compared with durable-polymer, drug-eluting stents (DES). However, arterial repair following deployment of the O-SES has not been elucidated to date. Methods and Results:
Using data from the Kansai Rosai Hospital database between November 2010 and September 2020, we analyzed coronary angioscopy (CAS) findings a mean (±SD) of 10±2 months after implantation of an O-SES, a durable-polymer everolimus-eluting stent (XienceTM; X-EES), or a biodegradable-polymer everolimus-eluting stent (SynergyTM; S-EES). Neointimal coverage (NIC), yellow color intensity of the stented segment, and the incidence of thrombus adhesion were compared between the O-SES (66 stents from 42 patients), X-EES (119 stents from 87 patients), and S-EES (132 stents from 88 patients). NIC was significantly thinner for the O-SES than S-EES (P<0.001), but was similar between the O-SES and X-EES (P=0.25). Yellow color intensity was significantly greater for the O-SES than X-EES (P<0.001), but similar between the O-SES and S-EES (P=0.51). The incidence of thrombus adhesions was similar in all 3 groups. Conclusions:
O-SES and X-EES resulted in similar inhibition of NIC and both resulted in a thinner NIC than with S-EES. In addition, O-SES exhibited a similar degree of thrombus adhesion as the other DES, suggesting similar thrombogenicity.
Collapse
Affiliation(s)
| | | | - Osamu Iida
- Kansai Rosai Hospital Cardiovascular Center Amagasaki Japan
| | - Yosuke Hata
- Kansai Rosai Hospital Cardiovascular Center Amagasaki Japan
| | - Taku Toyoshima
- Kansai Rosai Hospital Cardiovascular Center Amagasaki Japan
| | | | - Naoya Kurata
- Department of Clinical Engineering, Kansai Rosai Hospital Amagasaki Japan
| | | | | | - Shin Okamoto
- Kansai Rosai Hospital Cardiovascular Center Amagasaki Japan
| | - Kiyonori Nanto
- Kansai Rosai Hospital Cardiovascular Center Amagasaki Japan
| | - Takashi Kanda
- Kansai Rosai Hospital Cardiovascular Center Amagasaki Japan
| | | | - Toshiaki Mano
- Kansai Rosai Hospital Cardiovascular Center Amagasaki Japan
| |
Collapse
|
10
|
Migita S, Kitano D, Li Y, Koyama Y, Shimodai-Yamada S, Onishi A, Fuchimoto D, Suzuki S, Nakamura Y, Matsuyama TA, Hirota S, Sakuma M, Tsujimoto M, Hirayama A, Okumura Y, Hao H. Pathological findings after third- and second-generation everolimus-eluting stent implantations in coronary arteries from autopsy cases and an atherosclerotic porcine model. Sci Rep 2021; 11:6281. [PMID: 33737695 PMCID: PMC7973802 DOI: 10.1038/s41598-021-85740-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/23/2021] [Indexed: 01/10/2023] Open
Abstract
Pathological changes after third-generation drug-eluting stent implantation remain unclear. We compared the tissue responses of coronary arteries after the implantation of third-generation abluminal biodegradable-polymer everolimus-eluting stent (3rd EES) and second-generation durable-polymer EES (2nd EES) using autopsy specimens and an atherosclerotic porcine model. We compared the histology of stented coronary arteries obtained by autopsy performed 1–10 months after 3rd EES (n (number of cases) = 4, stent-implanted period of 3–7 months) and 2nd EES (n (number of cases) = 9, stent-implanted period of 1–10 months) implantations. The ratio of covered stent struts was higher with 3rd EESs than with 2nd EESs (3rd; 0.824 ± 0.032 vs. 2nd; 0.736 ± 0.022, p = 0.035). Low-density lipoprotein receptor knockout minipigs were stented with 3rd or 2nd EES in the coronary arteries and the stented regions were investigated. The fibrin deposition around the 2nd EES was more prominent. Additionally, higher density of smooth muscle cells was confirmed after the 3rd EES implantation. Pathological examination after the 3rd EES demonstrated a combination of less fibrin deposition and more rapid acquisition of well-developed neointima as compared to the 2nd EES at autopsy and the atherosclerotic porcine model.
Collapse
Affiliation(s)
- Suguru Migita
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.,Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Daisuke Kitano
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Yuxin Li
- Division of Cell Regeneration and Transplantation, Department of Functional Morphology, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
| | - Yutaka Koyama
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.,Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Sayaka Shimodai-Yamada
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan
| | - Akira Onishi
- Department of Animal Science and Resources, College of Bioresource Sciences, Nihon University, Kanagawa, Japan
| | - Daiichiro Fuchimoto
- Institute of Agrobiological Sciences, National Agriculture and Food Research Organization (NARO), Ibaraki, Japan
| | - Shunichi Suzuki
- Institute of Agrobiological Sciences, National Agriculture and Food Research Organization (NARO), Ibaraki, Japan
| | - Yoshiyuki Nakamura
- Swine and Poultry Research, Saitama Prefectural Agricultural Technology Research Center, Saitama, Japan
| | - Taka-Aki Matsuyama
- Department of Legal Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Seiichi Hirota
- Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Masashi Sakuma
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | | | | | - Yasuo Okumura
- Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Hiroyuki Hao
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
| |
Collapse
|
11
|
Nicol P, Hoppman P, Euller K, Xhepa E, Lenz T, Rai H, Jinnouchi H, Bulin A, Castellanos MI, Lahmann AL, Koppara T, Kastrati A, Joner M. Validation and application of OCT tissue attenuation index for the detection of neointimal foam cells. Int J Cardiovasc Imaging 2021; 37:25-35. [PMID: 32761285 PMCID: PMC7878214 DOI: 10.1007/s10554-020-01956-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/24/2020] [Indexed: 11/28/2022]
Abstract
Neointimal infiltration with foamy macrophages is recognized as an early and important sign of de-novo atherosclerosis after stent implantation (neoatherosclerosis). Recent histopathological studies have proven that automated quantification of signal attenuation using intravascular optical coherence tomography (OCT) imaging allows for sensitive identification of macrophages in native atherosclerotic disease. Whether this is true for neointimal foam cells in the setting of neoatherosclerosis remains unknown. Autopsy samples of stented coronary arteries (n = 13 cases) were evaluated by histology and OCT. After co-registration with histology, the attenuation rate of emitted laser light was measured in regions with and without neointimal foamy macrophages relative to its peak intensity at the blood-tissue interface. Attenuation index was subsequently determined as slope of a regression curve fitted to individual data points. Receiver operating curve (ROC) analysis was used to establish an optimal cut-off for detecting foamy macrophages in homogenous and non-homogenous neointima, respectively. Finally, the tissue attenuation index was applied to confirm or exclude the presence of neointimal foamy macrophages in symptomatic patients presenting with in-stent restenosis and undergoing intravascular OCT imaging (n = 29 cases). Tissue attenuation index derived from post-mortem samples differed significantly between histologically confirmed regions with and without neointimal foamy macrophages (- 1.23 ± 1.42 vs. - 0.52 ± 1.79, p < 0.05). ROC analysis was able to distinguish neointima with foamy macrophage infiltration from neointima without (93% sensitivity, 73% specificity, cut-off - 0.79, AUC 0.87 for homogenous neointima and 40% sensitivity, 95% specificity, cut-off - 1.93, AUC 0.69 for non-homogenous neointima). In symptomatic patients presenting with in-stent restenosis after stent implantation and undergoing intravascular imaging with OCT, neointimal foamy macrophages were detected in 34.2% of homogenous and 43.6% of non-homogenous neointimal ROI's evaluated. OCT-derived and histopathologically validated tissue attenuation index enables identification of neointimal foamy macrophages in stented coronary arteries. Such image-based post-processing software algorithm may help discern and triage subjects at increased risk for device-related events.
Collapse
Affiliation(s)
- Philipp Nicol
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse, 36, Munich, Germany
| | - Petra Hoppman
- Klinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Kristina Euller
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse, 36, Munich, Germany
| | - Erion Xhepa
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse, 36, Munich, Germany
| | - Tobias Lenz
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse, 36, Munich, Germany
| | - Himanshu Rai
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse, 36, Munich, Germany
| | - Hiroyuki Jinnouchi
- CVpath Institute Inc., a Non-profit Organization in Gaithersburg, Gaithersburg, MD, USA
| | - Anna Bulin
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse, 36, Munich, Germany
| | - Maria Isabel Castellanos
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse, 36, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Anna Lena Lahmann
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse, 36, Munich, Germany
| | - Tobias Koppara
- Klinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Adnan Kastrati
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse, 36, Munich, Germany
| | - Michael Joner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse, 36, Munich, Germany.
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.
| |
Collapse
|
12
|
Nicol P, Bulin A, Castellanos MI, Stöger M, Obermeier S, Lewerich J, Lenz T, Hoppmann P, Baumgartner C, Fischer J, Steiger K, Haude M, Joner M. Preclinical investigation of neoatherosclerosis in magnesium-based bioresorbable scaffolds versus thick-strut drug-eluting stents. EUROINTERVENTION 2020; 16:e922-e929. [PMID: 32583804 DOI: 10.4244/eij-d-19-00747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Neoatherosclerosis is a frequent finding after implantation of permanent metallic stents. Bioresorbable scaffolds (BRS) are considered to reduce the incidence of neoatherosclerosis owing to their dissolution and consequent vascular restoration. The aim of this study was to evaluate the formation of neoatherosclerosis between magnesium-based BRS and thick-strut metallic drug-eluting stents (DES) in a rabbit model of neoatherosclerosis and in proportion to the effect of high-dose statin medication. METHODS AND RESULTS Fully bioresorbable magnesium scaffolds (BRS, n=45) and thick-strut permanent metallic DES of equivalent geometry and design (n=45) were implanted into the iliac arteries of New Zealand White rabbits (n=45) following endothelial balloon injury and exposure to a cholesterol diet. Endothelialisation was assessed in 12 animals after 35 days using scanning electron microscopy (SEM), showing significantly enhanced re-endothelialisation above struts in the BRS (n=13) compared to DES (n=10). Eleven (11) animals were terminated for baseline assessment after 91 days while the remaining 22 animals were randomised to receive high-dose statin treatment (3 mg/kg) or placebo. BRS-treated vessels showed a significant reduction in foam cell infiltration as a sign of early neoatherosclerosis by histology and OCT when compared to thick-strut DES-treated vessels. Statin treatment resulted in significant reduction of foam cell infiltration in BRS and DES by histology. CONCLUSIONS Our findings suggest reduced neoatherosclerosis formation in magnesium-based BRS relative to thick-strut DES. High-dose statin treatment may be a promising measure to reduce neoatherosclerosis progression, both on its own and in synergy with site-targeted device-based treatment.
Collapse
Affiliation(s)
- Philipp Nicol
- Deutsches Herzzentrum München and Deutsches Zentrum für Herz-Kreislaufforschung e.V., Munich, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Caroff J, King RM, Ughi GJ, Marosfoi M, Langan ET, Raskett C, Puri AS, Gounis MJ. Longitudinal Monitoring of Flow-Diverting Stent Tissue Coverage After Implant in a Bifurcation Model Using Neurovascular High-Frequency Optical Coherence Tomography. Neurosurgery 2020; 87:1311-1319. [PMID: 32463884 PMCID: PMC7666887 DOI: 10.1093/neuros/nyaa208] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 03/19/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Tissue growth over covered branches is a leading cause of delayed thrombotic complications after flow-diverter stenting (FDS). Due to insufficient resolution, no imaging modality is clinically available to monitor this phenomenon. OBJECTIVE To evaluate high-frequency optical coherence tomography (HF-OCT), a novel intravascular imaging modality designed for the cerebrovascular anatomy with a resolution approaching 10 microns, to monitor tissue growth over FDS in an arterial bifurcation model. METHODS FDS were deployed in a rabbit model (n = 6), covering the aortic bifurcation. The animals were divided in different groups, receiving dual antiplatelet therapy (DAPT) (n = 4), aspirin only (n = 1), and no treatment (n = 1). HF-OCT data were obtained in vivo at 3 different time points in each animal. For each cross-sectional image, metal and tissue coverage of the jailed ostium was quantified. Scanning electron microscopy images of harvested arteries were subsequently obtained. RESULTS Good quality HF-OCT data sets were successfully acquired at implant and follow-up. A median value of 41 (range 21-55) cross-sectional images were analyzed per ostium for each time point. Between 0 and 30 d after implant, HF-OCT analysis showed a significantly higher ostium coverage when DAPT was not given. After 30 d, similar growth rates were found in the DAPT and in the aspirin group. At 60 d, a coverage of 90% was reached in all groups. CONCLUSION HF-OCT enables an accurate visualization of tissue growth over time on FDS struts. The use of FDS in bifurcation locations may induce a drastic reduction of the jailed-branch ostium area.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Matthew J Gounis
- Correspondence: Matthew J. Gounis, PhD, Department of Radiology, New England Center for Stroke Research, University of Massachusetts, 55 Lake Ave N, SA-107R, Worcester MA 01655, USA.
| |
Collapse
|
14
|
Ughi GJ, Marosfoi MG, King RM, Caroff J, Peterson LM, Duncan BH, Langan ET, Collins A, Leporati A, Rousselle S, Lopes DK, Gounis MJ, Puri AS. A neurovascular high-frequency optical coherence tomography system enables in situ cerebrovascular volumetric microscopy. Nat Commun 2020; 11:3851. [PMID: 32737314 PMCID: PMC7395105 DOI: 10.1038/s41467-020-17702-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 07/09/2020] [Indexed: 01/11/2023] Open
Abstract
Intravascular imaging has emerged as a valuable tool for the treatment of coronary and peripheral artery disease; however, no solution is available for safe and reliable use in the tortuous vascular anatomy of the brain. Endovascular treatment of stroke is delivered under image guidance with insufficient resolution to adequately assess underlying arterial pathology and therapeutic devices. High-resolution imaging, enabling surgeons to visualize cerebral arteries' microstructure and micron-level features of neurovascular devices, would have a profound impact in the research, diagnosis, and treatment of cerebrovascular diseases. Here, we present a neurovascular high-frequency optical coherence tomography (HF-OCT) system, including an imaging console and an endoscopic probe designed to rapidly acquire volumetric microscopy data at a resolution approaching 10 microns in tortuous cerebrovascular anatomies. Using a combination of in vitro, ex vivo, and in vivo models, the feasibility of HF-OCT for cerebrovascular imaging was demonstrated.
Collapse
Affiliation(s)
- Giovanni J Ughi
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
- Gentuity LLC, Sudbury, MA, USA
| | - Miklos G Marosfoi
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Neurointerventional Radiology, Beth Israel Lahey Clinic, Burlington, MA, USA
| | - Robert M King
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Jildaz Caroff
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Interventional Neuroradiology, NEURI Center, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | | | | | - Erin T Langan
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Amanda Collins
- Division of Translational Anatomy, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Anita Leporati
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | - Matthew J Gounis
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Ajit S Puri
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
| |
Collapse
|
15
|
Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferovic PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 2020; 40:87-165. [PMID: 30165437 DOI: 10.1093/eurheartj/ehy394] [Citation(s) in RCA: 3903] [Impact Index Per Article: 975.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
16
|
Lenz T, Nicol P, Castellanos MI, Abdelgalil AAA, Hoppmann P, Kempf W, Koppara T, Lahmann AL, Rüscher A, Kessler H, Joner M. Are we curing one evil with another? A translational approach targeting the role of neoatherosclerosis in late stent failure. Eur Heart J Suppl 2020; 22:C15-C25. [PMID: 32368195 PMCID: PMC7189739 DOI: 10.1093/eurheartj/suaa006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Neoatherosclerosis is defined as foamy macrophage infiltration into the peri-strut or neointimal area after stent implantation, potentially leading to late stent failure through progressive atherosclerotic changes including calcification, fibroatheroma, thin-cap fibroatheroma, and rupture with stent thrombosis (ST) in advanced stages. Human autopsy as well as intravascular imaging studies have led to the understanding of neoatherosclerosis formation as a similar but significantly accelerated pathophysiology as compared to native atherosclerosis. This acceleration is mainly based on disrupted endothelial integrity with insufficient barrier function and augmented transmigration of lipids following vascular injury after coronary intervention and especially after implantation of drug-eluting stents. In this review, we summarize translational insights into disease pathophysiology and discuss therapeutic approaches to tackle this novel disease entity. We introduce a novel animal model of neoatherosclerosis alongside accompanying in vitro experiments, which show impaired endothelial integrity causing increased permeability for low-density lipoprotein cholesterol resulting in foam cell transformation of human monocytes. In addition, we discuss novel intravascular imaging surrogates to improve reliable diagnosis of early stage neoatherosclerosis. Finally, a therapeutic approach to prevent in-stent neoatherosclerosis with magnesium-based bioresorbable scaffolds and systemic statin treatment demonstrated the potential to improve arterial healing and re-endothelialization, leading to significantly mitigated neoatherosclerosis formation in an animal model of neoatherosclerosis.
Collapse
Affiliation(s)
- Tobias Lenz
- Deutsches Herzzentrum München (German Heart Centre Munich), Klinik fβ Herz- und Kreislauferkrankungen, Technische Universität München, Lazarettstraße 36, 80363 Munich, Germany
| | - Philipp Nicol
- Deutsches Herzzentrum München (German Heart Centre Munich), Klinik fβ Herz- und Kreislauferkrankungen, Technische Universität München, Lazarettstraße 36, 80363 Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Biedersteiner Straße 29, 80802 Munich, Germany
| | - Maria Isabel Castellanos
- Deutsches Herzzentrum München (German Heart Centre Munich), Klinik fβ Herz- und Kreislauferkrankungen, Technische Universität München, Lazarettstraße 36, 80363 Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Biedersteiner Straße 29, 80802 Munich, Germany
| | - Ayat Aboutaleb Abdellah Abdelgalil
- Deutsches Herzzentrum München (German Heart Centre Munich), Klinik fβ Herz- und Kreislauferkrankungen, Technische Universität München, Lazarettstraße 36, 80363 Munich, Germany
| | - Petra Hoppmann
- Klinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Wolfgang Kempf
- Deutsches Herzzentrum München (German Heart Centre Munich), Klinik fβ Herz- und Kreislauferkrankungen, Technische Universität München, Lazarettstraße 36, 80363 Munich, Germany
| | - Tobias Koppara
- Klinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| | - Anna Lena Lahmann
- Deutsches Herzzentrum München (German Heart Centre Munich), Klinik fβ Herz- und Kreislauferkrankungen, Technische Universität München, Lazarettstraße 36, 80363 Munich, Germany
| | - Alena Rüscher
- Deutsches Herzzentrum München (German Heart Centre Munich), Klinik fβ Herz- und Kreislauferkrankungen, Technische Universität München, Lazarettstraße 36, 80363 Munich, Germany
| | - Horst Kessler
- Department of Chemistry and Center for Integrated Protein Science, Institute for Advanced Study, Technische Universität München, Lichtenbergstr. 4, 85747 Garching, Germany
| | - Michael Joner
- Deutsches Herzzentrum München (German Heart Centre Munich), Klinik fβ Herz- und Kreislauferkrankungen, Technische Universität München, Lazarettstraße 36, 80363 Munich, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Biedersteiner Straße 29, 80802 Munich, Germany
| |
Collapse
|
17
|
Kobayashi T, Sotomi Y, Suzuki S, Hamanaka Y, Nakatani S, Dijkstra J, Onuma Y, Serruys PW, Sakata Y, Hirayama A, Higuchi Y. Neointimal characteristics comparison between biodegradable-polymer and durable-polymer drug-eluting stents: 3-month follow-up optical coherence tomography light property analysis from the RESTORE registry. Int J Cardiovasc Imaging 2019; 36:205-215. [DOI: 10.1007/s10554-019-01718-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 10/18/2019] [Indexed: 10/25/2022]
|
18
|
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.
Collapse
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
| |
Collapse
|
19
|
Rai H, Hussein H, Colleran R, Xhepa E, Wiebe J, Pinieck S, Cassese S, Joner M, Kastrati A, Byrne RA, Foley DP. Optical Coherence Tomography Tissue Coverage and Characterization with Grey-Scale Signal Intensity Analysis After Bifurcation Stenting with a New Generation Bioabsorbable Polymer Drug-Eluting Stent. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2019; 21:277-285. [PMID: 31155492 DOI: 10.1016/j.carrev.2019.05.004] [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: 02/10/2019] [Revised: 04/29/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Bifurcation stenting is thought to be associated with delayed healing and a subsequent risk of stent failure. The aim of this study was to further evaluate healing of thin-strut bioabsorbable polymer everolimus-eluting stents (EES) post bifurcation stenting by optical coherence tomography (OCT) including grey-scale signal intensity (GSI) analysis. METHODS Patients undergoing bifurcation stenting with a planned two-stent approach using EES with OCT follow-up at 3-6 months post-stenting were included in this study. Morphometric analysis of contiguous cross-sections was performed at 1 mm longitudinal intervals within the stented segment. GSI analysis of neointimal regions of interest (ROI) overlying stent struts was performed for each of these cross-sections. Tissue coverage was classified as mature or immature. RESULTS Data on a total of 31 lesions (17 cases) was available at a median of 168 days post stenting. Mean length of stented segments was 27.7 ± 16.6 mm. The mean minimum stent area was 6.50 ± 2.71 mm2 while the mean stent area was 8.69 ± 3.08 mm2. Amongst a total of 847 assessed frames, 9716 struts were visible. Overall strut coverage was 95.9%; 0.3% of struts were malapposed. The mean thickness of neointimal coverage was 100.95 ± 42.03 μm and the mean percentage area stenosis was 9.03 ± 7.80%. A total of 53.79% of ROIs were classified as mature. CONCLUSIONS After implantation of EES in bifurcation lesions, rates of uncovered and malapposed struts were low. GSI analysis showed that more than half of neointimal areas analyzed were classified as mature in keeping with advanced vessel healing.
Collapse
Affiliation(s)
- Himanshu Rai
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | | | - Roisin Colleran
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Erion Xhepa
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Jens Wiebe
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Susanne Pinieck
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Salvatore Cassese
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Michael Joner
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Adnan Kastrati
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Robert A Byrne
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
| | | |
Collapse
|
20
|
Ishihara T, Tsujimura T, Okuno S, Iida O, Asai M, Masuda M, Okamoto S, Nanto K, Kanda T, Matsuda Y, Mano T. Early- and middle-phase arterial repair following bioresorbable- and durable-polymer drug-eluting stent implantation: An angioscopic study. Int J Cardiol 2019; 285:27-31. [DOI: 10.1016/j.ijcard.2019.02.059] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 01/11/2019] [Accepted: 02/25/2019] [Indexed: 11/28/2022]
|
21
|
Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferović PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. 2018 ESC/EACTS Guidelines on myocardial revascularization. EUROINTERVENTION 2019; 14:1435-1534. [PMID: 30667361 DOI: 10.4244/eijy19m01_01] [Citation(s) in RCA: 310] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Franz-Josef Neumann
- Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Qualitative and quantitative neointimal characterization by optical coherence tomography in patients presenting with in-stent restenosis. Clin Res Cardiol 2019; 108:1059-1068. [PMID: 30783752 DOI: 10.1007/s00392-019-01439-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2022]
Abstract
AIMS To describe optical coherence tomography (OCT) findings in patients with in-stent restenosis (ISR) and determine predictors of neointimal patterns and neoatherosclerosis. METHODS AND RESULTS Patients undergoing OCT prior to PCI for ISR in three European centres were included. Analyses were performed in a core laboratory. Qualitative and quantitative [gray-scale signal intensity (GSI)] neointima analyses were performed on a per quadrant basis. A total of 107 patients were included. Predominantly homogeneous lesions included 4.5% (0.0-14.3) non-homogeneous quadrants, while predominantly non-homogeneous ones included 28.1% (20.3-37.5) homogeneous quadrants. Mean GSI values differed significantly between homogeneous [108.4 (92.5-123.6)], non-homogeneous [79.9 (61.2-95.9)], and neoatherosclerosis [88.3 (72.8-104.9)] quadrants (p < 0.001 for all comparisons). Stent underexpansion was observed in 48.5% and 61.1% of lesions, respectively (p = 0.225). Female sex and maximal neointimal thickness independently correlate with a non-homogeneous pattern, while angiographic pattern and diabetes mellitus inversely correlate with such pattern. Time from index stenting procedure was the only independent predictor of neoatherosclerosis. CONCLUSIONS Different neointimal patterns coexist in a significant proportion of ISR lesions. GSI values differ significantly between neointimal categories. Neoatherosclerosis is a time-dependent phenomenon, displaying different time courses in DES compared to BMS, with earlier appearance in the former group. Stent underexpansion is a frequent finding in patients with ISR.
Collapse
|
23
|
Gounis MJ, Ughi GJ, Marosfoi M, Lopes DK, Fiorella D, Bezerra HG, Liang CW, Puri AS. Intravascular Optical Coherence Tomography for Neurointerventional Surgery. Stroke 2019; 50:218-223. [PMID: 30580737 PMCID: PMC6541539 DOI: 10.1161/strokeaha.118.022315] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Matthew J. Gounis
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester MA
| | - Giovanni J. Ughi
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester MA
| | - Miklos Marosfoi
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester MA
| | | | - David Fiorella
- Department of Neurosurgery, Stony Brook University, Stony Brook NY
| | - Hiram G. Bezerra
- Harrington Heart and Vascular Center, University Hospitals Cleveland Medical Center, Cleveland OH
| | - Conrad W. Liang
- Department of Neurosurgery, Kaiser Permanente Fontana Medical Center, Fontana CA
| | - Ajit S. Puri
- New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester MA
| |
Collapse
|
24
|
Perkins LEL, Rippy MK. Balloons and Stents and Scaffolds: Preclinical Evaluation of Interventional Devices for Occlusive Arterial Disease. Toxicol Pathol 2018; 47:297-310. [DOI: 10.1177/0192623318815604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Atherosclerosis places a significant burden on humankind; it is the leading cause of mortality globally, and for those living with atherosclerosis, it can significantly impact quality of life. Fortunately, treatment advances have effectively reduced the morbidity and mortality related to atherosclerosis, with one such modality being percutaneous intervention (PCI) to open occluded arteries. Over the 40-year history of PCI, preclinical models have played a critical role in demonstrating proof of concept, characterizing the in vivo behavior (pharmacokinetics, degradation) and providing a reasonable assurance of biologic safety of interventional devices before entering into clinical trials. Further, preclinical models may provide insight into the potential efficacy of these devices with the appropriate study design and end points. While several species have been used in the evaluation of interventional devices, the porcine model has been the principal model used in the evaluation of safety of devices for both coronary and endovascular treatments. This article reviews the fundamentals of permanent stents, transient scaffolds, and drug-coated balloons and the models, objectives, and methods used in their preclinical evaluation.
Collapse
|
25
|
Association Between TG-to-HDL-C Ratio and In-Stent Stenosis Under Optical Coherence Tomography Guidance. J Med Syst 2018; 43:4. [PMID: 30460580 DOI: 10.1007/s10916-018-1119-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/02/2018] [Indexed: 10/27/2022]
Abstract
We determined the relevance between the TG-to-HDL-C ratio and stent restenosis. Ninety-nine patients with in-stent stenosis (ISR) who were admitted to An Zhen Hospital in Beijing between April 2014 and June 2017 were selected. At the same time, 122 patients with coronary stenosis <50% were selected. All patients were tested for TG, HDL-C, and TG/HDL-C ratio. Optical coherence tomography (OCT) can assess microscopic status in all ISR patients. The proportion of male and Diabetic patients were significantly higher for ISR. There were differences in the prevalence of cigarette smokers among the different tissue types, among which the layered tissue type accounted for the highest proportion. In logistic regression analysis the study showed that male, diabetes mellitus, and the TG/HDL-C ratio are risk factors for ISR. The ISR ROC was 0.725 based on the TG/HDL-C ratio diagnosis. It is related to the degree of coronary stenosis and effective in diagnosing in-stent stenosis in ISR.
Collapse
|
26
|
Shi SY, Chen KL, Gu J, Xu C, Chen QR, Chen YQ, Xu T, Ke HY, Sun JH, Ye F. Correlation between pre-procedural plaque morphology and patterns of in-stent neointimal hyperplasia at 1-year follow-up in patients treated with new-generation drug-eluting stents: An optical coherence tomography based analysis. J Interv Cardiol 2018; 31:737-746. [PMID: 30251273 DOI: 10.1111/joic.12555] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 07/24/2018] [Accepted: 08/07/2018] [Indexed: 10/28/2022] Open
Abstract
INSTRUCTION Several factors affect the in-stent intimal healing process after drug-eluting stents (DESs) implantation. We hope to investigate the influence of plaque characteristics on subsequent heterogeneous neointimal hyperplasia (NIH) using optical coherence tomography (OCT). METHODS The study population consisted 217 patients with single-vessel de novo lesions who underwent both pre-procedural OCT scan and 12-month follow-up OCT examination. NIH is defined as at least five consecutive cross-sectional images with no less than 100µm neointimal thickness. According to OCT follow-up, patients were divided into three groups: neointima-covered group, homogeneous, and heterogeneous NIH group. RESULTS 102 patients were categorized in neointima-covered group, 91 and 24 patients in homogeneous and heterogeneous group, respectively. Time interval between OCT scans was similar (P = 0.55). No significant differences in the patients' age, gender, comorbidities, laboratory findings, procedural, and lesion-related findings were found among these three groups. Heterogeneous group tended to have more subjects presented as acute coronary syndrome (ACS) (P = 0.04) and mean macrophage grade was higher in this group (P = 0.01). While no statistically significant difference concerning mean intimal thickness (P = 0.21) or neointimal burden (P = 0.73) was found between homogeneous and heterogeneous group. Multivariate logistic regression analysis showed that mean macrophage grade (OR: 2.26, 95%CI: 1.12 to 4.53, P = 0.02) and initial clinical presentation of ACS (OR: 2.81, 95%CI: 1.03 to 7.72, P = 0.04) were significant independent risk factors for heterogeneous NIH. CONCLUSION Mean macrophage grade measured by OCT as a semi-quantitative morphological risk factor, as well as clinical presentation of ACS, was associated with in-stent neointimal heterogeneity after DES implantation.
Collapse
Affiliation(s)
- Shun-Yi Shi
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.,Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Kai-Lun Chen
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jue Gu
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Chen Xu
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Qian-Ru Chen
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yu-Qiao Chen
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Tian Xu
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Hai-Yan Ke
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Jian-Hui Sun
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Fei Ye
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| |
Collapse
|
27
|
Sousa-Uva M, Neumann FJ, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferovic PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur J Cardiothorac Surg 2018; 55:4-90. [PMID: 30165632 DOI: 10.1093/ejcts/ezy289] [Citation(s) in RCA: 347] [Impact Index Per Article: 57.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
|
28
|
Sotomi Y, Onuma Y, Liu S, Asano T, Eggermont J, Katagiri Y, Cavalcante R, de Winter RJ, Wykrzykowska JJ, Brugaletta S, Räber L, Sabaté M, Windecker S, Dijkstra J, Serruys PW. Quality difference of neointima following the implantation of everolimus-eluting bioresorbable scaffolds and metallic stents in patients with ST-elevation myocardial infarction: quantitative assessments by light intensity, light attenuation, and backscatter on optical coherence tomography in the TROFI II trial. EUROINTERVENTION 2018; 14:678-685. [DOI: 10.4244/eij-d-17-00884] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
29
|
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.
Collapse
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.)
| |
Collapse
|
30
|
Randomised comparison of vascular response to biodegradable polymer sirolimus eluting and permanent polymer everolimus eluting stents: An optical coherence tomography study. Int J Cardiol 2018; 258:42-49. [DOI: 10.1016/j.ijcard.2018.01.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 12/22/2017] [Accepted: 01/02/2018] [Indexed: 11/23/2022]
|
31
|
Kretov Е, Naryshkin I, Baystrukov V, Grazhdankin I, Prokhorikhin A, Zubarev D, Biryukov A, Verin V, Boykov A, Malaev D, Pokushalov E, Romanov A, Bergmann MW. Three-months optical coherence tomography analysis of a biodegradable polymer, sirolimus-eluting stent. J Interv Cardiol 2018; 31:442-449. [PMID: 29651802 DOI: 10.1111/joic.12510] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 02/07/2017] [Accepted: 03/01/2018] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE We aimed to assess early neointimal healing by optical coherence tomography (OCT) 3 months after implantation of the ultrathin Orsiro® sirolimus-eluting stent with biodegradable polymer. BACKGROUND New generations of drug-eluting stents with biodegradable polymer have been developed to avoid the continued vascular irritation of durable polymers. METHODS In this prospective, open-label study, 34 patients received an Orsiro® sirolimus-eluting stent with biodegradable polymer. In a subgroup of patients (n = 15), the intervention was performed under OCT guidance. All patients underwent OCT-examination at three months. The primary endpoint was 3-month neointimal healing (NIH) score, calculated by weighing the presence of filling defects, malapposed and uncovered struts. Secondary endpoint was maturity of tissue coverage at 3 months. RESULTS At 3 months, NIH score was 13.7 (5.4-22), covered struts per lesion were 90% (84-97%), malapposed struts were 2.7% (0.8-5.4%) and rate of mature tissue coverage was 47% (42-53%). No target lesion failure occurred up to 12 months. Patients with OCT-guided stent implantation demonstrated a trend toward earlier stent healing as demonstrated by superior NIH scores (angio guided: 17.6% [8.8-26.4]; OCT-guided: 9.8% [4.0-15.5]; mean difference -8, [95%CI: -18.7-2.9], P = 0.123). This group had significantly more covered struts per lesion (angio-guided: 86% [82-90]; 95% [92-99]; mean difference 9% [95%CI: 3-15], P = 0.001). CONCLUSION The Orsiro® sirolimus-eluting stent with biodegradable polymer shows early vascular healing with a high rate of strut coverage at 3-month follow-up. OCT guided stent implantation had a positive impact on early vascular healing.
Collapse
Affiliation(s)
- Еvgeny Kretov
- Novosibirsk Scientific Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Ivan Naryshkin
- Novosibirsk Scientific Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Vitaly Baystrukov
- Novosibirsk Scientific Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Igor Grazhdankin
- Novosibirsk Scientific Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Aleksei Prokhorikhin
- Novosibirsk Scientific Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Dmitry Zubarev
- Novosibirsk Scientific Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Alexey Biryukov
- Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | | | - Andrey Boykov
- Novosibirsk Scientific Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Dastan Malaev
- Novosibirsk Scientific Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Evgeny Pokushalov
- Novosibirsk Scientific Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Alexander Romanov
- Novosibirsk Scientific Research Institute of Circulation Pathology, Novosibirsk, Russian Federation
| | - Martin W Bergmann
- Interventional Cardiology, Cardiologicum Hamburg Standort Wandsbek, Hamburg, Germany
| |
Collapse
|
32
|
What Treatment Should We Dare in Patients With In-Stent Restenosis? JACC Cardiovasc Interv 2018; 11:284-286. [DOI: 10.1016/j.jcin.2017.11.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 11/21/2017] [Indexed: 11/24/2022]
|
33
|
Katagiri Y, Tenekecioglu E, Serruys PW, Collet C, Katsikis A, Asano T, Miyazaki Y, Piek JJ, Wykrzykowska JJ, Bourantas C, Onuma Y. What does the future hold for novel intravascular imaging devices: a focus on morphological and physiological assessment of plaque. Expert Rev Med Devices 2017; 14:985-999. [DOI: 10.1080/17434440.2017.1407646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Yuki Katagiri
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Carlos Collet
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Athanasios Katsikis
- Department of Cardiology, General Military Hospital of Athens, Athens, Greece
| | - Taku Asano
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Yosuke Miyazaki
- ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jan J Piek
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Christos Bourantas
- Barts Heart Centre, Barts Health NHS Trust, London, UK
- Institute of Cardiovascular Sciences, University College London, London, UK
| | - Yoshinobu Onuma
- ThoraxCenter, Erasmus Medical Center, Rotterdam, The Netherlands
| |
Collapse
|
34
|
McCutcheon K, Triantafyllis AS, Bennett J, Adriaenssens T. Unusually aggressive immature neo-intimal hyperplasia causing in-stent restenosis. Cardiovasc J Afr 2017; 28:404-405. [PMID: 29019519 PMCID: PMC5917250 DOI: 10.5830/cvja-2017-024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/19/2017] [Indexed: 11/06/2022] Open
Abstract
This image illustrates a very unusual pattern of early and aggressive immature neo-intimal hyperplasia in a 52-year-old man with unstable angina, two months after deployment of a drug-eluting stent in the proximal left anterior descending artery.
Collapse
Affiliation(s)
- Keir McCutcheon
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium.
| | | | - Johan Bennett
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Tom Adriaenssens
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
35
|
Collet JP, Roffi M, Byrne RA, Costa F, Valgimigli M, Valgimigli M, Bueno H, Byrne RA, Collet JP, Costa F, Jeppsson A, Jüni P, Kastrati A, Kolh P, Mauri L, Montalescot G, Neumann FJ, Petricevic M, Roffi M, Steg PG, Windecker S, Zamorano JL, Badimon L, Vranckx P, Agewall S, De Luca L, Desmet W, James S, Lettino M, McFadden EP, Storey R, Ten Berg JM, Aboyans V, Jofresa AB, Biščević A, Calabrò P, Constantinides S, Damrina E, Diakite M, Dzudovic B, Ruiz VG, Yáñez IK, Lacalzada-Almeida J, Leite L, Maskon O, Myat LL, Ricottini E, Saporito F, Wong PSC, Yamaji K, Zeitouni M. Case-based implementation of the 2017 ESC Focused Update on Dual Antiplatelet Therapy in Coronary Artery Disease. Eur Heart J 2017; 39:e1-e33. [DOI: 10.1093/eurheartj/ehx503] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
|
36
|
Adriaenssens T, Joner M, Godschalk TC, Malik N, Alfonso F, Xhepa E, De Cock D, Komukai K, Tada T, Cuesta J, Sirbu V, Feldman LJ, Neumann FJ, Goodall AH, Heestermans T, Buysschaert I, Hlinomaz O, Belmans A, Desmet W, Ten Berg JM, Gershlick AH, Massberg S, Kastrati A, Guagliumi G, Byrne RA. Optical Coherence Tomography Findings in Patients With Coronary Stent Thrombosis: A Report of the PRESTIGE Consortium (Prevention of Late Stent Thrombosis by an Interdisciplinary Global European Effort). Circulation 2017; 136:1007-1021. [PMID: 28720725 PMCID: PMC5598909 DOI: 10.1161/circulationaha.117.026788] [Citation(s) in RCA: 174] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 06/30/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Stent thrombosis (ST) is a serious complication following coronary stenting. Intravascular optical coherence tomography (OCT) may provide insights into mechanistic processes leading to ST. We performed a prospective, multicenter study to evaluate OCT findings in patients with ST. METHODS Consecutive patients presenting with ST were prospectively enrolled in a registry by using a centralized telephone registration system. After angiographic confirmation of ST, OCT imaging of the culprit vessel was performed with frequency domain OCT. Clinical data were collected according to a standardized protocol. OCT acquisitions were analyzed at a core laboratory. Dominant and contributing findings were adjudicated by an imaging adjudication committee. RESULTS Two hundred thirty-one patients presenting with ST underwent OCT imaging; 14 (6.1%) had image quality precluding further analysis. Of the remaining patients, 62 (28.6%) and 155 (71.4%) presented with early and late/very late ST, respectively. The underlying stent type was a new-generation drug-eluting stent in 50.3%. Mean reference vessel diameter was 2.9±0.6 mm and mean reference vessel area was 6.8±2.6 mm2. Stent underexpansion (stent expansion index <0.8) was observed in 44.4% of patients. The predicted average probability (95% confidence interval) that any frame had uncovered (or thrombus-covered) struts was 99.3% (96.1-99.9), 96.6% (92.4-98.5), 34.3% (15.0-60.7), and 9.6% (6.2-14.5) and malapposed struts was 21.8% (8.4-45.6), 8.5% (4.6-15.3), 6.7% (2.5-16.3), and 2.0% (1.2-3.3) for acute, subacute, late, and very late ST, respectively. The most common dominant finding adjudicated for acute ST was uncovered struts (66.7% of cases); for subacute ST, the most common dominant finding was uncovered struts (61.7%) and underexpansion (25.5%); for late ST, the most common dominant finding was uncovered struts (33.3%) and severe restenosis (19.1%); and for very late ST, the most common dominant finding was neoatherosclerosis (31.3%) and uncovered struts (20.2%). In patients presenting very late ST, uncovered stent struts were a common dominant finding in drug-eluting stents, and neoatherosclerosis was a common dominant finding in bare metal stents. CONCLUSIONS In patients with ST, uncovered and malapposed struts were frequently observed with the incidence of both decreasing with longer time intervals between stent implantation and presentation. The most frequent dominant observation varied according to time intervals from index stenting: uncovered struts and underexpansion in acute/subacute ST and neoatherosclerosis and uncovered struts in late/very late ST.
Collapse
Affiliation(s)
- Tom Adriaenssens
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Michael Joner
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Thea C Godschalk
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Nikesh Malik
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Fernando Alfonso
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Erion Xhepa
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Dries De Cock
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Kenichi Komukai
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Tomohisa Tada
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Javier Cuesta
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Vasile Sirbu
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Laurent J Feldman
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Franz-Josef Neumann
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Alison H Goodall
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Ton Heestermans
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Ian Buysschaert
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Ota Hlinomaz
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Ann Belmans
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Walter Desmet
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Jurrien M Ten Berg
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Anthony H Gershlick
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Steffen Massberg
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Adnan Kastrati
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Giulio Guagliumi
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.)
| | - Robert A Byrne
- From Department of Cardiology, University Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven, Belgium (T.A., D.D.C., W.D.); Deutsches Herzzentrum München, Technische Universität München, Germany (M.J., E.X., T.T., A.K., R.A.B.); Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands (T.C.G., J.M.t.B.); Department of Cardiovascular Sciences, University of Leicester & Leicester NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, United Kingdom (N.M., A.H. Goodall, A.H. Gershlick); Hospital Universitario de La Princesa, Madrid, Spain (F.A., J.C.); Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy (K.K., V.S., G.G.); Département de Cardiologie, AP-HP, DHU FIRE, U-1148 INSERM, Hôpital Bichat, Paris, France (L.J.F.); Universitäts- Herzzentrum Freiburg-Bad Krozingen, Germany (F.-J.N.); Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands (T.H.); Antwerp Cardiovascular Institute, ZNA Middelheim, Belgium (I.B.); Department of Cardiology, ICRC, St. Anne University Hospital, Masaryk University, Brno, Czech Republic (O.H.); Department of Biostatstics (I-BioStat), KU Leuven - University of Leuven & Universiteit Hasselt, Belgium (A.B.); Medizinische Klinik und Poliklinik I, Ludwig-Maximilians-Universität, Munich, Germany (S.M.); and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Germany (S.M., A.K., M.J., R.A.B.).
| | | |
Collapse
|
37
|
Echeverri D. ¿Somos conscientes de una nueva nomenclatura de aterosclerosis? REVISTA COLOMBIANA DE CARDIOLOGÍA 2017. [DOI: 10.1016/j.rccar.2017.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
38
|
Echeverri D. Are we aware of a new atherosclerosis nomenclature? REVISTA COLOMBIANA DE CARDIOLOGÍA 2017. [DOI: 10.1016/j.rccar.2017.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
39
|
Sato T, Jose J, El-Mawardy M, Sulimov DS, Tölg R, Richardt G, Abdel-Wahab M. Relationship between peri-strut low intensity areas and vascular healing response after everolimus-eluting bioresorbable scaffold implantation: An optical coherence tomography study. J Cardiol 2017; 69:606-612. [DOI: 10.1016/j.jjcc.2016.06.013] [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: 05/04/2016] [Revised: 06/23/2016] [Accepted: 06/28/2016] [Indexed: 11/15/2022]
|
40
|
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]
|
41
|
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.
Collapse
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
| |
Collapse
|
42
|
Joner M, Giacoppo D, Kastrati A. Molecular multimodality imaging: has a long-standing dream come true? Eur Heart J 2017; 38:456-458. [PMID: 26802135 DOI: 10.1093/eurheartj/ehv768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Daniele Giacoppo
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Adnan Kastrati
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| |
Collapse
|
43
|
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
| |
Collapse
|
44
|
Guha Roy A, Conjeti S, Carlier SG, Dutta PK, Kastrati A, Laine AF, Navab N, Katouzian A, Sheet D. Lumen Segmentation in Intravascular Optical Coherence Tomography Using Backscattering Tracked and Initialized Random Walks. IEEE J Biomed Health Inform 2016; 20:606-14. [DOI: 10.1109/jbhi.2015.2403713] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
45
|
Calcagno C, Mulder WJM, Nahrendorf M, Fayad ZA. Systems Biology and Noninvasive Imaging of Atherosclerosis. Arterioscler Thromb Vasc Biol 2016; 36:e1-8. [PMID: 26819466 PMCID: PMC4861402 DOI: 10.1161/atvbaha.115.306350] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Claudia Calcagno
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.).
| | - Willem J M Mulder
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.)
| | - Matthias Nahrendorf
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.)
| | - Zahi A Fayad
- From the Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY (C.C., W.J.M.M., Z.A.F.); Department of Medical Biochemistry, Academic Medical Center, Amsterdam, The Netherlands (W.J.M.M.); and Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (M.N.)
| |
Collapse
|
46
|
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
| |
Collapse
|
47
|
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.
Collapse
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
| |
Collapse
|
48
|
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
| |
Collapse
|
49
|
Jang JY, Kim JS, Shin DH, Kim BK, Ko YG, Choi D, Jang Y, Hong MK. Favorable effect of optimal lipid-lowering therapy on neointimal tissue characteristics after drug-eluting stent implantation: Qualitative optical coherence tomographic analysis. Atherosclerosis 2015; 242:553-9. [DOI: 10.1016/j.atherosclerosis.2015.08.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 08/06/2015] [Accepted: 08/08/2015] [Indexed: 01/05/2023]
|
50
|
Romero ME, Yahagi K, Kolodgie FD, Virmani R. Neoatherosclerosis From a Pathologist’s Point of View. Arterioscler Thromb Vasc Biol 2015; 35:e43-9. [DOI: 10.1161/atvbaha.115.306251] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|