Kenichi Yanaka1, Akihide Konishi1,2, Toshiro Shinke1,3, Amane Kozuki4, Hiroyuki Kawamori1, Yoshiro Tsukiyama1, Osamu Iida5, Makoto Kadotani6, Takashi Omori2, Ken-Ichi Hirata1. 1. Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine. 2. Clinical & Translational Research Center, Kobe University Hospital. 3. Division of Cardiology, Department of Medicine, Showa University School of Medicine. 4. Division of Cardiology, Osaka Saiseikai Nakatsu Hospital. 5. Cardiovascular Center, Kansai Rosai Hospital. 6. Kakogawa Central City Hospital.
Abstract
Objectives: Balloon angioplasty for in-stent restenosis (ISR) in the superficial femoral artery (SFA) has a high recurrent restenosis rate; however, its mechanism has not been fully and precisely evaluated using high-resolution intravascular imaging. Thus, we aimed to evaluate the relationship between vascular features obtained by optical frequency domain imaging (OFDI) and recurrent restenosis at 6 months. Methods: This was a prospective multicenter single-arm study. OFDI was performed before and after balloon angioplasty, and vascular features were assessed. A multi-layered ISR pattern detected by OFDI was defined as several signal-poor appearances with a high-signal band adjacent to the luminal surface. The primary outcome was defined as recurrent restenosis 6 months after balloon angioplasty. Results: Given that this study was terminated early, only 18 patients completed the 6-month follow-up; of these, 8 developed restenosis. Recurrent restenosis at 6 months tended to be related to a multi-layered ISR pattern (odds ratio (OR), 6.67; 95% confidence interval (CI), 0.81-54.96; p=0.078) and the minimum lumen area (MLA) after balloon angioplasty (OR, 0.71; 95%CI, 0.48-1.04; p=0.077). Conclusion: A multi-layered ISR pattern and MLA after balloon angioplasty detected by OFDI might be risk factors for recurrent ISR in the SFA.
Objectives: Balloon angioplasty for in-stent restenosis (ISR) in the superficial femoral artery (SFA) has a high recurrent restenosis rate; however, its mechanism has not been fully and precisely evaluated using high-resolution intravascular imaging. Thus, we aimed to evaluate the relationship between vascular features obtained by optical frequency domain imaging (OFDI) and recurrent restenosis at 6 months. Methods: This was a prospective multicenter single-arm study. OFDI was performed before and after balloon angioplasty, and vascular features were assessed. A multi-layered ISR pattern detected by OFDI was defined as several signal-poor appearances with a high-signal band adjacent to the luminal surface. The primary outcome was defined as recurrent restenosis 6 months after balloon angioplasty. Results: Given that this study was terminated early, only 18 patients completed the 6-month follow-up; of these, 8 developed restenosis. Recurrent restenosis at 6 months tended to be related to a multi-layered ISR pattern (odds ratio (OR), 6.67; 95% confidence interval (CI), 0.81-54.96; p=0.078) and the minimum lumen area (MLA) after balloon angioplasty (OR, 0.71; 95%CI, 0.48-1.04; p=0.077). Conclusion: A multi-layered ISR pattern and MLA after balloon angioplasty detected by OFDI might be risk factors for recurrent ISR in the SFA.
Authors: Takayuki Okamura; Nieves Gonzalo; Juan Luis Gutiérrez-Chico; Patrick W Serruys; Nico Bruining; Sebastiaan de Winter; Jouke Dijkstra; Koen H Commossaris; Robert-Jan van Geuns; Gijs van Soest; Jurgen Ligthart; Evelyn Regar Journal: EuroIntervention Date: 2010-08 Impact factor: 6.534
Authors: N Gonzalo; P W Serruys; T Okamura; Z J Shen; Y Onuma; H M Garcia-Garcia; G Sarno; C Schultz; R J van Geuns; J Ligthart; E Regar Journal: Heart Date: 2009-08-10 Impact factor: 5.994