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Qualitative assessment of neointimal tissue after drug-eluting stent implantation: comparison between follow-up optical coherence tomography and intravascular ultrasound.

 Sung Woo Kwon  ;  Byeong-Keuk Kim  ;  Tae-Hoon Kim  ;  Jung-Sun Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong-Ki Hong 
 American Heart Journal, Vol.161(2) : 367-372, 2011 
Journal Title
 American Heart Journal 
Issue Date
BACKGROUND: Characterization of neointimal tissue is essential to understand the pathophysiology of in-stent restenosis after drug-eluting stent (DES) implantation. We compared the morphological characteristics of neointimal tissue as assessed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in patients treated with DES. METHODS: A total of 243 patients (250 lesions) underwent follow-up OCT and IVUS after DES implantation. RESULTS: Mean time interval from DES implantation to follow-up OCT/IVUS was 12.0 ± 9.3 (range 2.8-68.5) months. Percent neointimal hyperplasia (NIH) cross-sectional area (CSA) was calculated as (NIH CSA/stent CSA) × 100 for receiver-operating characteristic analysis of NIH detection by IVUS; the optimal cutoff value of percent NIH CSA was 14.7%, as determined by OCT (sensitivity 0.887, specificity 0.790). Neointimal hyperplasia was detected by both OCT and IVUS in 121 of 250 lesions and categorized as homogenous (OCT n = 74, IVUS n = 107), heterogeneous (OCT n = 34, IVUS n = 4), or layered (OCT n = 13, IVUS n = 10). Of the 121 NIH lesions, nonhomogenous NIH was detected in 14 (11.6%) by IVUS and 47 (38.8%) by OCT. Optical coherence tomography and IVUS assessments of NIH morphology showed a moderate correlation (P < .001, r = 0.455); however, assessments differed in 37 (30.6%) of 121 lesions. CONCLUSION: Optical coherence tomography-assessed NIH morphology might be different from that by IVUS in about 30% of the lesions that were treated with DES implantation.
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
고영국(Ko, Young Guk) ; 권성우(Kwon, Sung Woo) ; 김병극(Kim, Byeong Keuk) ; 김중선(Kim, Jung Sun) ; 김태훈(Kim, Tae-Hoon) ; 장양수(Jang, Yang Soo) ; 최동훈(Choi, Dong Hoon) ; 홍명기(Hong, Myeong Ki)
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