BACKGROUND: We recently reported delayed angiographic restenosis in 15 patients who received 7-hexanoyltaxol (QP2)-eluting polymer stents (QuaDS) for the treatment of in-stent restenosis. This study presents the histological findings of atherectomy specimens from a subset of these patients receiving implants. METHODS AND RESULTS: Between October and December 2001, 5 patients treated with QuaDS-QP2 stents underwent directional coronary atherectomy at 11.2+/-1.0 months for recurrent in-stent restenosis. Restenotic lesion composition was assessed with special stains, immunohistochemistry with quantitative image analysis, and, in one specimen, transmission electron microscopy. Atherectomy specimens contained fibrin interspersed in a smooth muscle cell-rich neointima with proteoglycan matrix. In 2 of 5 specimens, large aggregates of macrophages and T-lymphocytes were noted. These areas of active inflammation demonstrated a relatively high proliferation index by Ki-67 antibody staining, whereas the proliferation index in smooth muscle cell-rich restenotic areas was low. CONCLUSION: Restenotic lesions from QuaDS-QP2-eluting stents at 12 months show persistent fibrin deposition with varying degrees of inflammation. These pathological changes, representing delayed healing, are usually observed up to only 3 months in human coronary arteries with stainless steel balloon-expandable stents. The nonreabsorbable polymer alone may have induced chronic inflammation.
BACKGROUND: We recently reported delayed angiographic restenosis in 15 patients who received 7-hexanoyltaxol (QP2)-eluting polymer stents (QuaDS) for the treatment of in-stent restenosis. This study presents the histological findings of atherectomy specimens from a subset of these patients receiving implants. METHODS AND RESULTS: Between October and December 2001, 5 patients treated with QuaDS-QP2 stents underwent directional coronary atherectomy at 11.2+/-1.0 months for recurrent in-stent restenosis. Restenotic lesion composition was assessed with special stains, immunohistochemistry with quantitative image analysis, and, in one specimen, transmission electron microscopy. Atherectomy specimens contained fibrin interspersed in a smooth muscle cell-rich neointima with proteoglycan matrix. In 2 of 5 specimens, large aggregates of macrophages and T-lymphocytes were noted. These areas of active inflammation demonstrated a relatively high proliferation index by Ki-67 antibody staining, whereas the proliferation index in smooth muscle cell-rich restenotic areas was low. CONCLUSION: Restenotic lesions from QuaDS-QP2-eluting stents at 12 months show persistent fibrin deposition with varying degrees of inflammation. These pathological changes, representing delayed healing, are usually observed up to only 3 months in human coronary arteries with stainless steel balloon-expandable stents. The nonreabsorbable polymer alone may have induced chronic inflammation.
Authors: Carlos L Alviar; Armando Tellez; Michael Wang; Pamela Potts; Doug Smith; Manus Tsui; Wladyslaw Budzynski; Albert E Raizner; Neal S Kleiman; Eli I Lev; Juan F Granada; Greg L Kaluza Journal: J Thromb Thrombolysis Date: 2012-07 Impact factor: 2.300
Authors: Salvatore Brugaletta; Hector M Garcia-Garcia; Scot Garg; Josep Gomez-Lara; Roberto Diletti; Yoshinobu Onuma; Robert Jan van Geuns; Dougal McClean; Dariusz Dudek; Leif Thuesen; Bernard Chevalier; Stephan Windecker; Robert Whitbourn; Cecile Dorange; Karine Miquel-Hebert; Krishnankutty Sudhir; John A Ormiston; Patrick W Serruys Journal: Int J Cardiovasc Imaging Date: 2010-10-13 Impact factor: 2.357
Authors: Natalie Artzi; Abraham R Tzafriri; Keith M Faucher; Geoffrey Moodie; Theresa Albergo; Suzanne Conroy; Scott Corbeil; Paul Martakos; Renu Virmani; Elazer R Edelman Journal: Ann Biomed Eng Date: 2015-08-28 Impact factor: 3.934
Authors: Michail I Papafaklis; Christos S Katsouras; Panagiotis E Theodorakis; Christos V Bourantas; Dimitrios I Fotiadis; Lampros K Michalis Journal: Heart Vessels Date: 2007-07-20 Impact factor: 2.037