Simard Trevor, Jung Richard, Di Santo Pietro, Sarathy Kiran, Majeed Kamran, Motazedian Pouya, Short Spencer, Dhaliwal Shan, Labinaz Alisha, Sarma Dhruv, Ramirez F Daniel, Froeschl Michael, Labinaz Marino, Holmes David R, Alkhouli Mohamad, Hibbert Benjamin
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Room H4238, Ottawa, ON, Canada.
J Cardiovasc Transl Res. 2023 Oct;16(5):1194-1204. doi: 10.1007/s12265-023-10399-1. Epub 2023 May 25.
Percutaneous coronary intervention (PCI) is a management strategy for symptomatic obstructive coronary artery disease (CAD). Despite advancements, in-stent restenosis (ISR) still imparts a 1-2% annual rate of repeat revascularization-a focus of ongoing translational research. Optical coherence tomography (OCT) provides high resolution virtual histology of stents. Our study evaluates the use of OCT for virtual histological assessment of stent healing in a rabbit aorta model, enabling complete assessment of intraluminal healing throughout the stent. ISR varies based on intra-stent location, stent length, and stent type in a rabbit model-important considerations for translational experimental design. Atherosclerosis leads to more prominent ISR proliferation independent of stent-related factors. The rabbit stent model mirrors clinical observations, while OCT-based virtual histology demonstrates utility for pre-clinical stent assessment. Pre-clinical models should incorporate clinical and stent factors as feasible to maximize translation to clinical practice.
经皮冠状动脉介入治疗（PCI）是有症状的阻塞性冠状动脉疾病（CAD）的一种治疗策略。尽管取得了进展，但支架内再狭窄（ISR）每年仍会导致1%-2%的再次血运重建率，这是当前转化研究的一个重点。光学相干断层扫描（OCT）可提供支架的高分辨率虚拟组织学图像。我们的研究评估了在兔主动脉模型中使用OCT进行支架愈合的虚拟组织学评估，从而能够对整个支架内的管腔愈合进行全面评估。在兔模型中，ISR因支架内位置、支架长度和支架类型而异，这是转化实验设计中需要考虑的重要因素。动脉粥样硬化会导致更显著的ISR增殖，而与支架相关因素无关。兔支架模型反映了临床观察结果，而基于OCT的虚拟组织学显示了其在临床前支架评估中的实用性。临床前模型应尽可能纳入临床和支架因素，以最大限度地转化为临床实践。
