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Formation and Transformation of Neointima after Drug-eluting Stent Implantation: Insights from Optical Coherence Tomographic Studies.

Authors
 Seung-Yul Lee  ;  Myeong-Ki Hong  ;  Yangsoo Jang 
Citation
 KOREAN CIRCULATION JOURNAL, Vol.47(6) : 823-832, 2017 
Journal Title
 KOREAN CIRCULATION JOURNAL 
ISSN
 1738-5520 
Issue Date
2017
Keywords
Coronary artery disease ; Drug-eluting stents ; Optical coherence tomography
Abstract
After coronary stent implantation, neointima formation resembles the wound healing process as it involves the sequential processes of inflammation, granulation, and remodeling. Because antiproliferative drugs and polymers of drug-eluting stents (DESs) delay vascular healing compared with bare metal stents, fibrin deposition can remain long after stent implantation, or inflammation can be excessive. Delayed vascular healing can be associated with adverse clinical outcomes including DES thrombosis or restenosis, and poor endothelization of DES neointima can accelerate neoatherosclerotic change inside the neointima, further contributing to luminal restenosis or neointimal instability. Despite the lack of correlation between pathologic and optical coherence tomography (OCT) findings, OCT assessments of neointima under various circumstances can reveal vascular responses to stent therapy. Homogeneous, heterogeneous, and layered neointima patterns can be recognized by OCT and can change with time. Homogeneous neointima might be associated with better clinical outcomes after DES implantation, whereas non-homogeneous neointima or neoatherosclerotic change can be associated with poorer clinical outcomes. However, limited data are currently available, and further studies are required to comprehensively address these questions.
Files in This Item:
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DOI
10.4070/kcj.2017.0157
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165771
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