International Heart Journal
Online ISSN : 1349-3299
Print ISSN : 1349-2365
Clinical Studies
Clinical Significance of Low Signal Intensity Area Surrounding Stent Struts Identified by Optical Coherence Tomography
Kohei IshibashiAtsushi TanakaHironori KitabataTakashi KuboManabu KashiwagiKenichi KomukaiYasushi InoTakashi TanimotoKazushi TakemotoShigeho TakaradaKumiko HirataMasato MizukoshiToshio ImanishiTakashi Akasaka
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Volume 54 (2013) Issue 1 Pages 7-10

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Abstract

Previous intravascular ultrasound studies have shown that echolucent neointimal hyperplasia occasionally appears after bare-metal stent (BMS) or sirolimus-eluting stent (SES) implantation. Optical coherence tomography (OCT) studies have also demonstrated that paclitaxel-eluting stent (PES) restenosis exhibited similar images showing low signal intensity areas (LSIA) surrounding stent struts and three-layer appearance (TLA). The aim of the present study was to investigate the clinical significance of LSIA on OCT images in various types of stents. Fifty nine consecutive patients who underwent scheduled follow-up coronary angiography and OCT were enrolled. There was no significant difference in the prevalence of LSIA among the 3 stent groups (BMS 30%, SES 19%, PES 28%, P = 0.70). LSIA thickness was larger in the PES group than in the other stent groups (BMS 0.51 ± 0.21 mm, SES 0.35 ± 0.06 mm, PES 0.87 ± 0.19 mm, P < 0.01). The ratio of LSIA thickness to the neointimal thickness was also larger in PES compared with other stents (BMS 53 ± 9 %, SES 57 ± 8 %, PES 77 ± 5 %, P < 0.01). Also, LSIA thickness in patients with in-stent restenosis (ISR) was significantly larger than in those without ISR (0.37 ± 0.37 mm versus 0.12 ± 0.26 mm, P = 0.048). Our results suggest that LSIA might be involved in excessive neointimal formation, and that the healing response after PES implantation might be different from BMS or SES.

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© 2013 by the International Heart Journal Association
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