AIMS: Although optical coherence tomography (OCT) is capable to detect microscopic peri-strut changes that seem to be related to neointimal inhibition and healing, its ability to characterize these components is still limited. In this study, we aimed to compare different OCT morphological characteristics with different in-stent neointimal tissue types analysed by histology. METHODS: A total of 69 stents (39 drug eluting and 30 bare metal stents) were implanted in coronary arteries of 27 swine. By OCT, neointimal type was classified as homogeneous, heterogeneous, or layered according to its pattern of backscatter and optical intensity. The resulting optical patterns were correlated with several histological findings [external elastic lamina (EEL) disruption, fibrin deposition, circumferential rim of peri-strut inflammatory cell infiltration, and fibrous connective deposition] in every single cross-section (CS) analysed. RESULTS: A total of 197 matched OCT and histological CS were analysed. The heterogeneous (0.44 ± 0.21 mm) and layered (0.65 ± 0.16 mm) patterns had a significantly higher degree of neointimal thickness compared with the homogeneous pattern (0.25 ± 0.16 mm, P < 0.001). Fibrous connective tissue deposition was more frequently present in the homogeneous pattern (71.6%, P < 0.001), whereas significant fibrin deposits were more commonly seen in the heterogeneous pattern (56.9%, P = 0.007). Peri-strut inflammation was less frequently found in the homogeneous pattern (19.8%, P < 0.001) in comparison with the layered (73.9%) or heterogeneous patterns (43.1%). The presence of EEL rupture was also more commonly seen in layered (73.9%) and heterogeneous (46.6%) patterns than in the homogeneous pattern (22.4%, P < 0.001). CONCLUSION: The optical characteristics of neointimal formation seen in OCT properly correlated with the presence of several histological findings involved in stent healing. The biological implications of these findings in clinical outcomes require further investigation.
AIMS: Although optical coherence tomography (OCT) is capable to detect microscopic peri-strut changes that seem to be related to neointimal inhibition and healing, its ability to characterize these components is still limited. In this study, we aimed to compare different OCT morphological characteristics with different in-stent neointimal tissue types analysed by histology. METHODS: A total of 69 stents (39 drug eluting and 30 bare metal stents) were implanted in coronary arteries of 27 swine. By OCT, neointimal type was classified as homogeneous, heterogeneous, or layered according to its pattern of backscatter and optical intensity. The resulting optical patterns were correlated with several histological findings [external elastic lamina (EEL) disruption, fibrin deposition, circumferential rim of peri-strut inflammatory cell infiltration, and fibrous connective deposition] in every single cross-section (CS) analysed. RESULTS: A total of 197 matched OCT and histological CS were analysed. The heterogeneous (0.44 ± 0.21 mm) and layered (0.65 ± 0.16 mm) patterns had a significantly higher degree of neointimal thickness compared with the homogeneous pattern (0.25 ± 0.16 mm, P < 0.001). Fibrous connective tissue deposition was more frequently present in the homogeneous pattern (71.6%, P < 0.001), whereas significant fibrin deposits were more commonly seen in the heterogeneous pattern (56.9%, P = 0.007). Peri-strut inflammation was less frequently found in the homogeneous pattern (19.8%, P < 0.001) in comparison with the layered (73.9%) or heterogeneous patterns (43.1%). The presence of EEL rupture was also more commonly seen in layered (73.9%) and heterogeneous (46.6%) patterns than in the homogeneous pattern (22.4%, P < 0.001). CONCLUSION: The optical characteristics of neointimal formation seen in OCT properly correlated with the presence of several histological findings involved in stent healing. The biological implications of these findings in clinical outcomes require further investigation.
Authors: Makoto Araki; Seung-Jung Park; Harold L Dauerman; Shiro Uemura; Jung-Sun Kim; Carlo Di Mario; Thomas W Johnson; Giulio Guagliumi; Adnan Kastrati; Michael Joner; Niels Ramsing Holm; Fernando Alfonso; William Wijns; Tom Adriaenssens; Holger Nef; Gilles Rioufol; Nicolas Amabile; Geraud Souteyrand; Nicolas Meneveau; Edouard Gerbaud; Maksymilian P Opolski; Nieves Gonzalo; Guillermo J Tearney; Brett Bouma; Aaron D Aguirre; Gary S Mintz; Gregg W Stone; Christos V Bourantas; Lorenz Räber; Sebastiano Gili; Kyoichi Mizuno; Shigeki Kimura; Toshiro Shinke; Myeong-Ki Hong; Yangsoo Jang; Jin Man Cho; Bryan P Yan; Italo Porto; Giampaolo Niccoli; Rocco A Montone; Vikas Thondapu; Michail I Papafaklis; Lampros K Michalis; Harmony Reynolds; Jacqueline Saw; Peter Libby; Giora Weisz; Mario Iannaccone; Tommaso Gori; Konstantinos Toutouzas; Taishi Yonetsu; Yoshiyasu Minami; Masamichi Takano; O Christopher Raffel; Osamu Kurihara; Tsunenari Soeda; Tomoyo Sugiyama; Hyung Oh Kim; Tetsumin Lee; Takumi Higuma; Akihiro Nakajima; Erika Yamamoto; Krzysztof L Bryniarski; Luca Di Vito; Rocco Vergallo; Francesco Fracassi; Michele Russo; Lena M Seegers; Iris McNulty; Sangjoon Park; Marc Feldman; Javier Escaned; Francesco Prati; Eloisa Arbustini; Fausto J Pinto; Ron Waksman; Hector M Garcia-Garcia; Akiko Maehara; Ziad Ali; Aloke V Finn; Renu Virmani; Annapoorna S Kini; Joost Daemen; Teruyoshi Kume; Kiyoshi Hibi; Atsushi Tanaka; Takashi Akasaka; Takashi Kubo; Satoshi Yasuda; Kevin Croce; Juan F Granada; Amir Lerman; Abhiram Prasad; Evelyn Regar; Yoshihiko Saito; Mullasari Ajit Sankardas; Vijayakumar Subban; Neil J Weissman; Yundai Chen; Bo Yu; Stephen J Nicholls; Peter Barlis; Nick E J West; Armin Arbab-Zadeh; Jong Chul Ye; Jouke Dijkstra; Hang Lee; Jagat Narula; Filippo Crea; Sunao Nakamura; Tsunekazu Kakuta; James Fujimoto; Valentin Fuster; Ik-Kyung Jang Journal: Nat Rev Cardiol Date: 2022-04-21 Impact factor: 49.421
Authors: Jung Sun Kim; Seul Gee Lee; Jaewon Oh; Sungha Park; Se Il Park; Sung Yu Hong; Sehoon Kim; Sang Hak Lee; Young Guk Ko; Donghoon Choi; Myeong Ki Hong; Yangsoo Jang Journal: Yonsei Med J Date: 2016-09 Impact factor: 2.759
Authors: Jacek Bil; Robert J Gil; Adam Kern; Tomasz Pawłowski; Piotr Seweryniak; Zbigniew Śliwiński Journal: BMC Cardiovasc Disord Date: 2015-11-14 Impact factor: 2.298
Authors: Robert J Gil; Jacek Bil; Jacek Legutko; Tomasz Pawłowski; Katarzyna E Gil; Dariusz Dudek; Ricardo A Costa Journal: Int J Cardiovasc Imaging Date: 2017-09-30 Impact factor: 2.357