Neointimal progression and luminal narrowing in sirolimus-eluting stent treatment for bare metal in-stent restenosis: A quantitative intravascular ultrasound analysis
Background Recurrent restenosis may occur after drug-eluting stent implantation for in-stent restenosis (ISR) of bare metal stents (BMSs), especially in areas involving drug-eluting stent gaps. Methods To investigate the details of neointimal progression and luminal narrowing after the treatment of...
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| Veröffentlicht in: | The American heart journal 2007-08, Vol.154 (2), p.361-365 |
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| creator | Sakurai, Ryota, MD Ako, Junya, MD Hassan, Ali H.M., MD Bonneau, Heidi N., RN, MS Neumann, Franz-Josef, MD Desmet, Walter, MD Holmes, David R., MD Yock, Paul G., MD Fitzgerald, Peter J., MD, PhD Honda, Yasuhiro, MD |
| description | Background Recurrent restenosis may occur after drug-eluting stent implantation for in-stent restenosis (ISR) of bare metal stents (BMSs), especially in areas involving drug-eluting stent gaps. Methods To investigate the details of neointimal progression and luminal narrowing after the treatment of ISR using sirolimus-eluting stents (SESs), serial intravascular ultrasound analysis was performed in 65 patients with ISR at postintervention and at 6-month follow-up. The total stented segment was categorized into 3 compartments: new SES (N), new SES and old BMS overlap (N/O), and old BMS (O). In each of the 190 compartments, serial intravascular ultrasound parameters were analyzed at the cross section of the maximum change in neointimal area (Δneointimal area) from postintervention to follow-up or the minimum lumen area at follow-up if Δneointimal area was 0. Minimum lumen area in each compartment was also investigated serially. Results At postintervention, lumen area was the smallest in compartment N/O (N 5.8 ± 1.5, N/O 5.1 ± 1.3, O 6.0 ± 1.4 mm2 , P = .005). Not only the average of maximum Δneointimal area (N 0.2 ± 0.4, N/O 0.2 ± 0.4, O 0.8 ± 1.0 mm2 , P < .0001) but also the frequency of minimum lumen area decreasing from ≥4.0 mm2 at postintervention to |
| doi_str_mv | 10.1016/j.ahj.2007.04.023 |
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Methods To investigate the details of neointimal progression and luminal narrowing after the treatment of ISR using sirolimus-eluting stents (SESs), serial intravascular ultrasound analysis was performed in 65 patients with ISR at postintervention and at 6-month follow-up. The total stented segment was categorized into 3 compartments: new SES (N), new SES and old BMS overlap (N/O), and old BMS (O). In each of the 190 compartments, serial intravascular ultrasound parameters were analyzed at the cross section of the maximum change in neointimal area (Δneointimal area) from postintervention to follow-up or the minimum lumen area at follow-up if Δneointimal area was 0. Minimum lumen area in each compartment was also investigated serially. Results At postintervention, lumen area was the smallest in compartment N/O (N 5.8 ± 1.5, N/O 5.1 ± 1.3, O 6.0 ± 1.4 mm2 , P = .005). Not only the average of maximum Δneointimal area (N 0.2 ± 0.4, N/O 0.2 ± 0.4, O 0.8 ± 1.0 mm2 , P < .0001) but also the frequency of minimum lumen area decreasing from ≥4.0 mm2 at postintervention to <4.0 mm2 at follow-up (N 4.0%, N/O 5.1%, O 23.5%, P = .012) was the largest in compartment O. Conclusions Neointimal progression and consequent luminal narrowing tend to occur where BMS is uncovered with SES in treatment of ISR, even in the absence of an obvious stenosis at postintervention.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2007.04.023</identifier><identifier>PMID: 17643589</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Anatomy, Cross-Sectional ; Angioplasty ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular ; Clinical trials ; Coronary Restenosis - diagnostic imaging ; Coronary Restenosis - drug therapy ; Coronary vessels ; Disease Progression ; Drug Delivery Systems ; Female ; Humans ; Immunosuppressive Agents - administration & dosage ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Radiation therapy ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Sirolimus - administration & dosage ; Statistical analysis ; Stents ; Studies ; Tunica Intima - diagnostic imaging ; Ultrasonic imaging ; Ultrasonography, Interventional ; Veins & arteries</subject><ispartof>The American heart journal, 2007-08, Vol.154 (2), p.361-365</ispartof><rights>2007</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Elsevier Limited Aug 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c530t-b28c713550b2dfa6faa17ce2150e708dbb89f521a12c4d969715ac136d5b97333</citedby><cites>FETCH-LOGICAL-c530t-b28c713550b2dfa6faa17ce2150e708dbb89f521a12c4d969715ac136d5b97333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1504608297?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19101444$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17643589$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sakurai, Ryota, MD</creatorcontrib><creatorcontrib>Ako, Junya, MD</creatorcontrib><creatorcontrib>Hassan, Ali H.M., MD</creatorcontrib><creatorcontrib>Bonneau, Heidi N., RN, MS</creatorcontrib><creatorcontrib>Neumann, Franz-Josef, MD</creatorcontrib><creatorcontrib>Desmet, Walter, MD</creatorcontrib><creatorcontrib>Holmes, David R., MD</creatorcontrib><creatorcontrib>Yock, Paul G., MD</creatorcontrib><creatorcontrib>Fitzgerald, Peter J., MD, PhD</creatorcontrib><creatorcontrib>Honda, Yasuhiro, MD</creatorcontrib><title>Neointimal progression and luminal narrowing in sirolimus-eluting stent treatment for bare metal in-stent restenosis: A quantitative intravascular ultrasound analysis</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Recurrent restenosis may occur after drug-eluting stent implantation for in-stent restenosis (ISR) of bare metal stents (BMSs), especially in areas involving drug-eluting stent gaps. Methods To investigate the details of neointimal progression and luminal narrowing after the treatment of ISR using sirolimus-eluting stents (SESs), serial intravascular ultrasound analysis was performed in 65 patients with ISR at postintervention and at 6-month follow-up. The total stented segment was categorized into 3 compartments: new SES (N), new SES and old BMS overlap (N/O), and old BMS (O). In each of the 190 compartments, serial intravascular ultrasound parameters were analyzed at the cross section of the maximum change in neointimal area (Δneointimal area) from postintervention to follow-up or the minimum lumen area at follow-up if Δneointimal area was 0. Minimum lumen area in each compartment was also investigated serially. Results At postintervention, lumen area was the smallest in compartment N/O (N 5.8 ± 1.5, N/O 5.1 ± 1.3, O 6.0 ± 1.4 mm2 , P = .005). Not only the average of maximum Δneointimal area (N 0.2 ± 0.4, N/O 0.2 ± 0.4, O 0.8 ± 1.0 mm2 , P < .0001) but also the frequency of minimum lumen area decreasing from ≥4.0 mm2 at postintervention to <4.0 mm2 at follow-up (N 4.0%, N/O 5.1%, O 23.5%, P = .012) was the largest in compartment O. Conclusions Neointimal progression and consequent luminal narrowing tend to occur where BMS is uncovered with SES in treatment of ISR, even in the absence of an obvious stenosis at postintervention.</description><subject>Aged</subject><subject>Anatomy, Cross-Sectional</subject><subject>Angioplasty</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Clinical trials</subject><subject>Coronary Restenosis - diagnostic imaging</subject><subject>Coronary Restenosis - drug therapy</subject><subject>Coronary vessels</subject><subject>Disease Progression</subject><subject>Drug Delivery Systems</subject><subject>Female</subject><subject>Humans</subject><subject>Immunosuppressive Agents - administration & dosage</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Radiation therapy</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Sirolimus - administration & dosage</subject><subject>Statistical analysis</subject><subject>Stents</subject><subject>Studies</subject><subject>Tunica Intima - diagnostic imaging</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Interventional</subject><subject>Veins & arteries</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9ksuKFDEUhoMoTtv6AG4kILqr9iR1SZWCMAzeYNCFug6pVGpMWZXM5NLSL-RzeopuaJiFq1z4_vOfnD-EPGewY8CaN9NO_Zp2HEDsoNoBLx-QDYNOFI2oqodkAwC8aAWUF-RJjBMeG942j8kFE01V1m23IX-_Gm9dsoua6W3wN8HEaL2jyg10zot1eO9UCP6PdTfUOhpt8LNdcizMnNN6GZNxiaZgVFrW3egD7VUwdDEJ1dYVRwJL4-qjjW_pJb3LCm2TSnZvkElB7VXUeVaB5hlP0WdsQaH_ARVPyaNRzdE8O61b8vPjhx9Xn4vrb5--XF1eF7ouIRU9b7VgZV1Dz4dRNaNSTGjDWQ1GQDv0fduNNWeKcV0NXdMJVivNymao-06UZbklr491cRZ3GRuWi43azLNyxucoBYiaAXQIvrwHTj4H7DZKNKsaaDkW3BJ2pHTwMQYzytuAow4HyUCuEcpJYoRyjVBCJTFC1Lw4Vc79Yoaz4pQZAq9OAA5MzWNQTtt45josXFUVcu-OnMGB7a0JMmprnDaDDUYnOXj73zbe31Pr2TqLhr_NwcTza2XkEuT39a-tXw0EQLna_wMBe9Io</recordid><startdate>20070801</startdate><enddate>20070801</enddate><creator>Sakurai, Ryota, MD</creator><creator>Ako, Junya, MD</creator><creator>Hassan, Ali H.M., MD</creator><creator>Bonneau, Heidi N., RN, MS</creator><creator>Neumann, Franz-Josef, MD</creator><creator>Desmet, Walter, MD</creator><creator>Holmes, David R., MD</creator><creator>Yock, Paul G., MD</creator><creator>Fitzgerald, Peter J., MD, PhD</creator><creator>Honda, Yasuhiro, MD</creator><general>Mosby, Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20070801</creationdate><title>Neointimal progression and luminal narrowing in sirolimus-eluting stent treatment for bare metal in-stent restenosis: A quantitative intravascular ultrasound analysis</title><author>Sakurai, Ryota, MD ; Ako, Junya, MD ; Hassan, Ali H.M., MD ; Bonneau, Heidi N., RN, MS ; Neumann, Franz-Josef, MD ; Desmet, Walter, MD ; Holmes, David R., MD ; Yock, Paul G., MD ; Fitzgerald, Peter J., MD, PhD ; Honda, Yasuhiro, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c530t-b28c713550b2dfa6faa17ce2150e708dbb89f521a12c4d969715ac136d5b97333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aged</topic><topic>Anatomy, Cross-Sectional</topic><topic>Angioplasty</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Clinical trials</topic><topic>Coronary Restenosis - diagnostic imaging</topic><topic>Coronary Restenosis - drug therapy</topic><topic>Coronary vessels</topic><topic>Disease Progression</topic><topic>Drug Delivery Systems</topic><topic>Female</topic><topic>Humans</topic><topic>Immunosuppressive Agents - administration & dosage</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Radiation therapy</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Sirolimus - administration & dosage</topic><topic>Statistical analysis</topic><topic>Stents</topic><topic>Studies</topic><topic>Tunica Intima - diagnostic imaging</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Interventional</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sakurai, Ryota, MD</creatorcontrib><creatorcontrib>Ako, Junya, MD</creatorcontrib><creatorcontrib>Hassan, Ali H.M., MD</creatorcontrib><creatorcontrib>Bonneau, Heidi N., RN, MS</creatorcontrib><creatorcontrib>Neumann, Franz-Josef, MD</creatorcontrib><creatorcontrib>Desmet, Walter, MD</creatorcontrib><creatorcontrib>Holmes, David R., MD</creatorcontrib><creatorcontrib>Yock, Paul G., MD</creatorcontrib><creatorcontrib>Fitzgerald, Peter J., MD, PhD</creatorcontrib><creatorcontrib>Honda, Yasuhiro, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sakurai, Ryota, MD</au><au>Ako, Junya, MD</au><au>Hassan, Ali H.M., MD</au><au>Bonneau, Heidi N., RN, MS</au><au>Neumann, Franz-Josef, MD</au><au>Desmet, Walter, MD</au><au>Holmes, David R., MD</au><au>Yock, Paul G., MD</au><au>Fitzgerald, Peter J., MD, PhD</au><au>Honda, Yasuhiro, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neointimal progression and luminal narrowing in sirolimus-eluting stent treatment for bare metal in-stent restenosis: A quantitative intravascular ultrasound analysis</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2007-08-01</date><risdate>2007</risdate><volume>154</volume><issue>2</issue><spage>361</spage><epage>365</epage><pages>361-365</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Recurrent restenosis may occur after drug-eluting stent implantation for in-stent restenosis (ISR) of bare metal stents (BMSs), especially in areas involving drug-eluting stent gaps. Methods To investigate the details of neointimal progression and luminal narrowing after the treatment of ISR using sirolimus-eluting stents (SESs), serial intravascular ultrasound analysis was performed in 65 patients with ISR at postintervention and at 6-month follow-up. The total stented segment was categorized into 3 compartments: new SES (N), new SES and old BMS overlap (N/O), and old BMS (O). In each of the 190 compartments, serial intravascular ultrasound parameters were analyzed at the cross section of the maximum change in neointimal area (Δneointimal area) from postintervention to follow-up or the minimum lumen area at follow-up if Δneointimal area was 0. Minimum lumen area in each compartment was also investigated serially. Results At postintervention, lumen area was the smallest in compartment N/O (N 5.8 ± 1.5, N/O 5.1 ± 1.3, O 6.0 ± 1.4 mm2 , P = .005). Not only the average of maximum Δneointimal area (N 0.2 ± 0.4, N/O 0.2 ± 0.4, O 0.8 ± 1.0 mm2 , P < .0001) but also the frequency of minimum lumen area decreasing from ≥4.0 mm2 at postintervention to <4.0 mm2 at follow-up (N 4.0%, N/O 5.1%, O 23.5%, P = .012) was the largest in compartment O. Conclusions Neointimal progression and consequent luminal narrowing tend to occur where BMS is uncovered with SES in treatment of ISR, even in the absence of an obvious stenosis at postintervention.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>17643589</pmid><doi>10.1016/j.ahj.2007.04.023</doi><tpages>5</tpages></addata></record> |
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| ispartof | The American heart journal, 2007-08, Vol.154 (2), p.361-365 |
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| subjects | Aged Anatomy, Cross-Sectional Angioplasty Biological and medical sciences Cardiology. Vascular system Cardiovascular Clinical trials Coronary Restenosis - diagnostic imaging Coronary Restenosis - drug therapy Coronary vessels Disease Progression Drug Delivery Systems Female Humans Immunosuppressive Agents - administration & dosage Male Medical imaging Medical sciences Middle Aged Radiation therapy Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Sirolimus - administration & dosage Statistical analysis Stents Studies Tunica Intima - diagnostic imaging Ultrasonic imaging Ultrasonography, Interventional Veins & arteries |
| title | Neointimal progression and luminal narrowing in sirolimus-eluting stent treatment for bare metal in-stent restenosis: A quantitative intravascular ultrasound analysis |
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