The role of integrated backscatter intravascular ultrasound in characterizing bare metal and drug-eluting stent restenotic neointima as compared to optical coherence tomography

Kastsumasa Sato, Charis Costopoulos, Hideo Takebayashi, Toru Naganuma, Tadashi Miyazaki, Kenji Goto, Hiroki Yamane, Arata Hagikura, Yuetsu Kikuta, Masahito Taniguchi, Shigeki Hiramatsu, Hiroshi Ito, Antonio Colombo, Seiichi Haruta

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Abstract

To evaluate the role of integrated backscatter intravascular ultrasound (IB-IVUS) in assessing the morphology of neointima in bare-metal stent (BMS) and drug-eluting stent (DES) restenosis as compared to the gold-standard, optical coherence tomography (OCT). Methods: A total of 120 cross-sections were evaluated by IB-IVUS and OCT at five cross-sections from 24 patients (24 lesions): at the minimal lumen area (MLA) and at 1 and 2. mm proximal and distal to the MLA site in 24 lesions (9 treated with DES and 15 treated with BMS). IB-IVUS and OCT findings were analyzed according to the time at which restenosis was identified (early <12 months and late ≥12 months) and the stent type. Results: IB-IVUS was found to correctly characterize the neointima of both BMS and DES in-stent restenosis (ISR) as compared to OCT. The overall agreement between the pattern of ISR neointima by IB-IVUS and that by OCT was excellent (kappa = 0.85, 95% CI 0.76-0.94). Late DES ISR was characterized by more non-homogeneous, low backscatter and lipid-laden neointima, as compared to the BMS equivalent (BMS vs. DES, 45.0% vs. 80.0%, p < 0.01; 51.7% vs. 85.0%, p = 0.008; 33.3% vs. 65.0%, p < 0.01, respectively). Conclusions: IB-IVUS assessment of the ISR neointima pattern appears to provide similar information as the gold-standard OCT in patients with stable angina. Both modalities suggested that late DES restenosis is characterized by a non-homogeneous lipid-laden neointima.

Original languageEnglish
Pages (from-to)488-495
Number of pages8
JournalJournal of Cardiology
Volume64
Issue number6
DOIs
Publication statusPublished - Jan 1 2014

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Keywords

  • In-stent restenosis
  • Integrated backscatter intravascular ultrasound
  • Neointima
  • Optical coherence tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Sato, K., Costopoulos, C., Takebayashi, H., Naganuma, T., Miyazaki, T., Goto, K., Yamane, H., Hagikura, A., Kikuta, Y., Taniguchi, M., Hiramatsu, S., Ito, H., Colombo, A., & Haruta, S. (2014). The role of integrated backscatter intravascular ultrasound in characterizing bare metal and drug-eluting stent restenotic neointima as compared to optical coherence tomography. Journal of Cardiology, 64(6), 488-495. https://doi.org/10.1016/j.jjcc.2014.03.007