Mohar Dilbahar S, Patel Pranav M, Grewal Alisha K, Mohar Prabhsimran, Kern Morton J
Division of Cardiology, Department of Medicine, University of California, Irvine School of Medicine, Irvine, California.
Int J Angiol. 2017 Sep;26(3):191-195. doi: 10.1055/s-0036-1583764. Epub 2016 May 26.
Although the use of drug-eluting stents (DES) has dramatically decreased the incidence of in-stent restenosis (ISR), concerns regarding the late manifestations of ISR remain. Optical coherence tomography (OCT) imaging provides unique insights into characteristics and patterns of ISR. We report a case of late DES ISR with unusual heterogeneous intracoronary luminal characteristics suggestive of vulnerable atherosclerotic plaque activity by OCT imaging. This case demonstrates that late ISR after DES may involve more than mere neointimal hyperplasia with lesion-associated craters, septae, and neoatherosclerosis. The use of OCT provides novel insights into the mechanisms and potential biology of the late DES ISR.
尽管药物洗脱支架（DES）的使用已显著降低了支架内再狭窄（ISR）的发生率，但对ISR晚期表现的担忧依然存在。光学相干断层扫描（OCT）成像为ISR的特征和模式提供了独特的见解。我们报告一例DES晚期ISR病例，其冠状动脉腔内具有不寻常的异质性特征，通过OCT成像提示易损动脉粥样硬化斑块活动。该病例表明，DES术后晚期ISR可能不仅仅涉及伴有病变相关坑洼、隔膜和新动脉粥样硬化的单纯内膜增生。OCT的应用为DES晚期ISR的机制和潜在生物学特性提供了新的见解。
