Shibuya Masahiko, Fujii Kenichi, Fukunaga Masashi, Imanaka Takahiro, Miki Kojiro, Tamaru Hiroto, Ohyanagi Mitsumasa, Masuyama Tohru
Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
Heart Vessels. 2015 Jan;30(1):136-9. doi: 10.1007/s00380-013-0450-y. Epub 2013 Dec 29.
Although previous optical coherence tomography (OCT) studies reported that restenosis tissue after implantation of a drug-eluting stent (DES) was composed of a variety of cells, the clinical significance of morphologic characteristics for in-stent neointimal tissue as assessed by OCT has not been clarified. We experienced a patient with stable angina who underwent percutaneous coronary intervention with a 2.5 × 18-mm DES implantation 6 months before the OCT examination. OCT imaging showed a mild intimal hyperplasia (39 % neointimal hyperplasia) with eccentric, heterogeneous tissue, predominantly of low signal intensity. Seventeen months after the initial procedure, OCT revealed a significant increase in percent neointimal hyperplasia of 58 %, with morphologically different intimal tissue of concentric homogeneous high intensity in the stented segments. This finding suggests that low-intensity intimal tissue morphology detected by OCT could be a morphometric predictor of late neointimal tissue growth after DES implantation.
尽管先前的光学相干断层扫描（OCT）研究报告称，药物洗脱支架（DES）植入后的再狭窄组织由多种细胞组成，但通过OCT评估的支架内新生内膜组织形态学特征的临床意义尚未阐明。我们遇到一名稳定型心绞痛患者，在进行OCT检查前6个月接受了2.5×18毫米DES植入的经皮冠状动脉介入治疗。OCT成像显示轻度内膜增生（39%内膜增生），组织偏心、异质性，主要为低信号强度。初始手术后17个月，OCT显示内膜增生百分比显著增加至58%，支架段内膜组织形态不同，呈同心均匀高强度。这一发现表明，OCT检测到的低强度内膜组织形态可能是DES植入后晚期内膜组织生长的形态学预测指标。
