Atherosclerotic Component of the Yellow Segment After Drug-Eluting Stent Implantation on Coronary Angioscopy ― An Ex-Vivo Validation Study
Background: Coronary angioscopy (CAS) is used to comprehensively evaluate vascular responses after drug-eluting stent (DES) implantation. This study sought to evaluate the capability of CAS for evaluating DES strut coverage grade and color grade of the intima compared with histological images in cor...
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| Published in | Circulation Journal Vol. 83; no. 1; pp. 193 - 197 |
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| Main Authors | , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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Japan
The Japanese Circulation Society
25.12.2018
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| Abstract | Background: Coronary angioscopy (CAS) is used to comprehensively evaluate vascular responses after drug-eluting stent (DES) implantation. This study sought to evaluate the capability of CAS for evaluating DES strut coverage grade and color grade of the intima compared with histological images in coronary autopsy specimens. Methods and Results: A total of 23 DES extracted from 11 autopsy hearts were imaged by CAS. All stent segments were graded as white or yellow according to the luminal surface color, and thrombus was evaluated according to a previous report. Neointimal coverage over the DES was graded as 0 (stent struts fully visible) to grade 3 (stent struts fully embedded and invisible). Of 76 segments, neointimal coverage was graded as 0 in 35 (46%), 1 in 22 (29%), 2 in 8 (11%), and 3 in 11 (14%). The neointimal thickness increased significantly with increasing neointimal coverage grade on angioscopy. Neointimal color was graded as white in 40 (53%) and yellow in 36 segments (47%). Histological analysis revealed that yellow neointima contained fibroatheroma, foam cells accumulation or superficial calcium deposition. A thrombus was identified in 13 segments. Thrombi adherent around the stent strut were partly intimal erythrocyte accumulation around the strut. Conclusions: In-stent yellow segment had atherosclerotic components. CAS could evaluate vascular status comprehensively after DES implantation. |
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| AbstractList | Background: Coronary angioscopy (CAS) is used to comprehensively evaluate vascular responses after drug-eluting stent (DES) implantation. This study sought to evaluate the capability of CAS for evaluating DES strut coverage grade and color grade of the intima compared with histological images in coronary autopsy specimens. Methods and Results: A total of 23 DES extracted from 11 autopsy hearts were imaged by CAS. All stent segments were graded as white or yellow according to the luminal surface color, and thrombus was evaluated according to a previous report. Neointimal coverage over the DES was graded as 0 (stent struts fully visible) to grade 3 (stent struts fully embedded and invisible). Of 76 segments, neointimal coverage was graded as 0 in 35 (46%), 1 in 22 (29%), 2 in 8 (11%), and 3 in 11 (14%). The neointimal thickness increased significantly with increasing neointimal coverage grade on angioscopy. Neointimal color was graded as white in 40 (53%) and yellow in 36 segments (47%). Histological analysis revealed that yellow neointima contained fibroatheroma, foam cells accumulation or superficial calcium deposition. A thrombus was identified in 13 segments. Thrombi adherent around the stent strut were partly intimal erythrocyte accumulation around the strut. Conclusions: In-stent yellow segment had atherosclerotic components. CAS could evaluate vascular status comprehensively after DES implantation. Coronary angioscopy (CAS) is used to comprehensively evaluate vascular responses after drug-eluting stent (DES) implantation. This study sought to evaluate the capability of CAS for evaluating DES strut coverage grade and color grade of the intima compared with histological images in coronary autopsy specimens. A total of 23 DES extracted from 11 autopsy hearts were imaged by CAS. All stent segments were graded as white or yellow according to the luminal surface color, and thrombus was evaluated according to a previous report. Neointimal coverage over the DES was graded as 0 (stent struts fully visible) to grade 3 (stent struts fully embedded and invisible). Of 76 segments, neointimal coverage was graded as 0 in 35 (46%), 1 in 22 (29%), 2 in 8 (11%), and 3 in 11 (14%). The neointimal thickness increased significantly with increasing neointimal coverage grade on angioscopy. Neointimal color was graded as white in 40 (53%) and yellow in 36 segments (47%). Histological analysis revealed that yellow neointima contained fibroatheroma, foam cells accumulation or superficial calcium deposition. A thrombus was identified in 13 segments. Thrombi adherent around the stent strut were partly intimal erythrocyte accumulation around the strut. In-stent yellow segment had atherosclerotic components. CAS could evaluate vascular status comprehensively after DES implantation. Coronary angioscopy (CAS) is used to comprehensively evaluate vascular responses after drug-eluting stent (DES) implantation. This study sought to evaluate the capability of CAS for evaluating DES strut coverage grade and color grade of the intima compared with histological images in coronary autopsy specimens.BACKGROUNDCoronary angioscopy (CAS) is used to comprehensively evaluate vascular responses after drug-eluting stent (DES) implantation. This study sought to evaluate the capability of CAS for evaluating DES strut coverage grade and color grade of the intima compared with histological images in coronary autopsy specimens.A total of 23 DES extracted from 11 autopsy hearts were imaged by CAS. All stent segments were graded as white or yellow according to the luminal surface color, and thrombus was evaluated according to a previous report. Neointimal coverage over the DES was graded as 0 (stent struts fully visible) to grade 3 (stent struts fully embedded and invisible). Of 76 segments, neointimal coverage was graded as 0 in 35 (46%), 1 in 22 (29%), 2 in 8 (11%), and 3 in 11 (14%). The neointimal thickness increased significantly with increasing neointimal coverage grade on angioscopy. Neointimal color was graded as white in 40 (53%) and yellow in 36 segments (47%). Histological analysis revealed that yellow neointima contained fibroatheroma, foam cells accumulation or superficial calcium deposition. A thrombus was identified in 13 segments. Thrombi adherent around the stent strut were partly intimal erythrocyte accumulation around the strut.METHODS AND RESULTSA total of 23 DES extracted from 11 autopsy hearts were imaged by CAS. All stent segments were graded as white or yellow according to the luminal surface color, and thrombus was evaluated according to a previous report. Neointimal coverage over the DES was graded as 0 (stent struts fully visible) to grade 3 (stent struts fully embedded and invisible). Of 76 segments, neointimal coverage was graded as 0 in 35 (46%), 1 in 22 (29%), 2 in 8 (11%), and 3 in 11 (14%). The neointimal thickness increased significantly with increasing neointimal coverage grade on angioscopy. Neointimal color was graded as white in 40 (53%) and yellow in 36 segments (47%). Histological analysis revealed that yellow neointima contained fibroatheroma, foam cells accumulation or superficial calcium deposition. A thrombus was identified in 13 segments. Thrombi adherent around the stent strut were partly intimal erythrocyte accumulation around the strut.In-stent yellow segment had atherosclerotic components. CAS could evaluate vascular status comprehensively after DES implantation.CONCLUSIONSIn-stent yellow segment had atherosclerotic components. CAS could evaluate vascular status comprehensively after DES implantation. |
| Author | Hao, Hiroyuki Imanaka, Takahiro Nishimura, Machiko Miki, Kojiro Horimatsu, Tetsuo Saita, Ten Shibuya, Masahiko Hirota, Seiichi Ishihara, Masaharu Sumiyoshi, Akinori Tamaru, Hiroto Fujii, Kenichi Kawakami, Rika Masuyama, Tohru |
| Author_xml | – sequence: 1 fullname: Shibuya, Masahiko organization: Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine – sequence: 2 fullname: Fujii, Kenichi organization: Department of Surgical Pathology, Hyogo College of Medicine – sequence: 3 fullname: Hao, Hiroyuki organization: Department of Pathology, Nihon University School of Medicine – sequence: 4 fullname: Imanaka, Takahiro organization: Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine – sequence: 5 fullname: Saita, Ten organization: Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine – sequence: 6 fullname: Kawakami, Rika organization: Department of Surgical Pathology, Hyogo College of Medicine – sequence: 7 fullname: Miki, Kojiro organization: Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine – sequence: 8 fullname: Tamaru, Hiroto organization: Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine – sequence: 9 fullname: Horimatsu, Tetsuo organization: Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine – sequence: 10 fullname: Sumiyoshi, Akinori organization: Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine – sequence: 11 fullname: Nishimura, Machiko organization: Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine – sequence: 12 fullname: Hirota, Seiichi organization: Department of Surgical Pathology, Hyogo College of Medicine – sequence: 13 fullname: Masuyama, Tohru organization: Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine – sequence: 14 fullname: Ishihara, Masaharu organization: Division of Cardiovascular Medicine and Coronary Heart Disease, Hyogo College of Medicine |
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| Cites_doi | 10.1016/j.jacc.2005.11.092 10.1016/j.jcmg.2011.05.008 10.1016/j.jcin.2014.12.239 10.1016/j.jjcc.2012.08.011 10.1016/j.jacc.2013.06.015 10.1016/j.jcin.2013.07.018 10.1007/s10554-016-0855-7 10.1161/01.STR.30.7.1319 10.1056/NEJMoa035655 10.1016/j.amjcard.2007.09.106 10.1253/circj.CJ-10-0776 10.1161/CIRCULATIONAHA.105.609057 10.1016/0140-6736(91)92514-3 10.1093/oxfordjournals.eurheartj.a060590 10.1016/j.jcmg.2009.01.011 10.1161/CIRCULATIONAHA.113.001790 |
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| Snippet | Background: Coronary angioscopy (CAS) is used to comprehensively evaluate vascular responses after drug-eluting stent (DES) implantation. This study sought to... Coronary angioscopy (CAS) is used to comprehensively evaluate vascular responses after drug-eluting stent (DES) implantation. This study sought to evaluate the... |
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| SubjectTerms | Aged Atherosclerosis Coronary angioscopy Coronary Artery Disease - metabolism Coronary Artery Disease - pathology Coronary Artery Disease - surgery Drug-Eluting Stents Female Humans Male Middle Aged Neointima - metabolism Neointima - pathology Plaque, Atherosclerotic - metabolism Plaque, Atherosclerotic - pathology Sirolimus - administration & dosage Vulnerable plaque |
| Title | Atherosclerotic Component of the Yellow Segment After Drug-Eluting Stent Implantation on Coronary Angioscopy ― An Ex-Vivo Validation Study |
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