Roleder Tomasz, Pociask Elżbieta, Wańha Wojciech, Dobrolińska Magdalena, Gąsior Paweł, Smolka Grzegorz, Walkowicz Wojciech, Jadczyk Tomasz, Bochenek Tomasz, Dudek Dariusz, Ochała Andrzej, Mizia-Stec Katarzyna, Gąsior Zbigniew, Tendera Michał, Ali Ziad A, Wojakowski Wojciech
Third Department of Cardiology, Medical University of Silesia.
Circ J. 2016 Jul 25;80(8):1804-11. doi: 10.1253/circj.CJ-16-0332. Epub 2016 Jun 21.
The OCTOPUS registry prospectively evaluates the procedural and long-term outcomes of saphenous vein graft (SVG) PCI. The current study assessed the morphology of de novo lesions and in-stent restenosis (ISR) in patients undergoing PCI of SVG.
Optical coherence tomography (OCT) of SVG lesions in consecutive patients presenting with stable CAD and ACS was carried out. Thirty-nine patients (32 de novo and 10 ISR lesions) were included in the registry. ISR occurred in 5 BMS and 5 DES. There were no differences in the presence of plaque rupture and thrombus between de novo lesions and ISR. Lipid-rich tissue was identified in both de novo lesions and in ISR (75% vs. 50%, P=0.071) with a higher prevalence in BMS than in DES (23% vs. 7.5%; P=0.048). Calcific de novo lesions were detected in older grafts as compared with non-calcific atheromas (159±57 vs. 90±62 months after CABG, P=0.001). Heterogeneous neointima was found only in ISR (70% vs. 0, P<0.001) and was observed with similar frequency in both BMS and DES (24% vs. 30%, P=0.657). ISR was detected earlier in DES than BMS (median, 50 months; IQR, 18-96 months vs. 27 months; IQR, 13-29 months, P<0.001).
OCT-based characteristics of de novo and ISR lesions in SVG were similar except for heterogeneous tissue, which was observed only in ISR. (Circ J 2016; 80: 1804-1811).
章鱼注册研究前瞻性评估了大隐静脉桥血管（SVG）经皮冠状动脉介入治疗（PCI）的手术及长期预后。本研究评估了接受SVG PCI患者的新发病变及支架内再狭窄（ISR）的形态。
对连续的稳定性冠心病和急性冠状动脉综合征患者的SVG病变进行光学相干断层扫描（OCT）。39例患者（32处新发病变和10处ISR病变）纳入注册研究。5例裸金属支架（BMS）和5例药物洗脱支架（DES）发生ISR。新发病变和ISR之间斑块破裂和血栓形成情况无差异。新发病变和ISR中均发现富含脂质组织（75%对50%，P=0.071），BMS中患病率高于DES（23%对7.5%；P=0.048）。与非钙化粥样斑块相比，钙化新发病变在较旧的移植血管中被检测到（冠状动脉旁路移植术后159±57个月对90±62个月，P=0.001）。仅在ISR中发现异质性内膜（70%对0，P<0.001），BMS和DES中观察到的频率相似（24%对30%，P=0.657）。DES中ISR的检测早于BMS（中位数，50个月；四分位间距，18 - 96个月对27个月；四分位间距，13 - 29个月，P<0.001）。
除了仅在ISR中观察到的异质性组织外，SVG中基于OCT的新发病变和ISR病变特征相似。（《循环杂志》2016年；80：1804 - 1811）
