Division of Cardiology, Sakurabashi Watanabe Hospital, Kita-Ku, Osaka, Japan.
Catheter Cardiovasc Interv. 2010 May 1;75(6):961-3. doi: 10.1002/ccd.22267.
We report on two patients with sirolimus-eluting stent (SES) restenosis lesions who showed highly echolucent regions by optical coherence tomography (OCT) and who could be assessed histologically after removal by directional coronary atherectomy (DCA). One restenosis lesion had a bilayer structure of hyperechoic outer layers and highly echolucent inner layers on OCT images and histologically exhibited myxomatous neointima tissue in the highly echolucent regions; another restenosis case showed patchy and highly echolucent regions throughout the layers and its histology revealed fibrin thrombosis. We should be aware that patterns of echolucent on OCT images may have various histology. OCT allows the visualization of fine lesions that conventional intravascular ultrasound (IVUS) cannot provide. The OCT images of drug-eluting stent restenosis lesions often show echolucent regions [Shuzoh et al., EuroInterv 2006;1:484]. However, no histological study of the lesions has been reported to date. Here we report on two patients with SES restenosis lesions that showed highly echolucent regions by OCT and that could be assessed histologically after removal by DCA.
我们报告了两例经光学相干断层扫描（OCT）显示高度回声不透明区域的西罗莫司洗脱支架（SES）再狭窄病变患者，他们在经定向冠状动脉旋磨术（DCA）切除后可进行组织学评估。一个再狭窄病变在 OCT 图像上具有外层高回声和内层高度回声不透明的双层结构，组织学上显示高度回声不透明区域为黏液样新生内膜组织；另一个再狭窄病例在各层均显示片状和高度回声不透明区域，其组织学显示为纤维蛋白血栓。我们应该意识到，OCT 图像上回声不透明的模式可能具有多种组织学。OCT 允许可视化常规血管内超声（IVUS）无法提供的细微病变。药物洗脱支架再狭窄病变的 OCT 图像通常显示回声不透明区域[Shuzoh 等人，EuroInterv 2006；1：484]。然而，迄今为止，尚未有关于这些病变的组织学研究报告。在这里，我们报告了两例 SES 再狭窄病变患者，他们经 OCT 显示高度回声不透明区域，并且可以在经 DCA 切除后进行组织学评估。
