反复支架内再狭窄的光学相干断层成像病变特征分析

目的:通过光学相干断层成像(OCT)对支架内再狭窄(ISR)患者病变特征进行分析,明确反复支架内再狭窄(R-ISR)及非R-ISR病变发生机制的异同,为进一步指导并优化ISR治疗提供依据.方法:回顾性入选2016年1月至2019年12月于中国医学科学院阜外医院行OCT检查的药物洗脱支架(DES)置入术后ISR患者52例...

Optical Coherence Tomography Features of Patients With Recurrent In-stent Restenosis

Objectives:To clarify the optical coherence tomography(OCT)features of recurrent in-stent restenosis(R-ISR)and non-R-ISR.Methods:A total of 52 patients with ISR after DES implantation who underwent OCT in Fuwai Hospital from January 2016 to December 2019 were retrospectively enrolled,and the patients were divided into R-ISR group(n=16)and non-R-ISR group(n=36).The data on patient demographics,cardiovascular risk factors,ancillary tests,previous interventional treatments,and other medical history were collected and anylyzed.The coronary angiography and OCT images of R-ISR and non-R-ISR patients were analyzed qualitatively and quantitatively.Results:There were no significant differences between R-ISR and non-R-ISR patients in terms of cardiovascular risk factors such as hypertension,hyperlipidemia,diabetes mellitus,smoking history,family history of coronary heart disease.The coronary angiographic characteristics such as lesion location,ISR classification,reference vessel diameter,target lesion length were also similar between the two groups(all P>0.05).The proportion of homogeneous neointima(43.8%)was significantly higher in R-ISR group than in non-R-ISR group(19.4%),and the proportion of neoatherosclerosis(43.8%)was significantly lower in R-ISR group than in non-R-ISR(75.0%,both P<0.05).Conclusions:Our results show the proportion of homogeneous neointima is higher in R-ISR patients,suggesting that enhanced fibroplasia might be an important mechanism of R-ISR.