Atherosclerotic Component of the Yellow Segment After Drug-Eluting Stent Implantation on Coronary Angioscopy ― An Ex-Vivo Validation Study ―

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Author(s)

Abstract

<p><b><i>Background: </i></b>Coronary angioscopy (CAS) is used to comprehensively evaluate vascular responses after drug-eluting stent (DES) implantation. This study sought to evaluate the capability of CAS for evaluating DES strut coverage grade and color grade of the intima compared with histological images in coronary autopsy specimens. </p><p><b><i>Methods and Results: </i></b>A total of 23 DES extracted from 11 autopsy hearts were imaged by CAS. All stent segments were graded as white or yellow according to the luminal surface color, and thrombus was evaluated according to a previous report. Neointimal coverage over the DES was graded as 0 (stent struts fully visible) to grade 3 (stent struts fully embedded and invisible). Of 76 segments, neointimal coverage was graded as 0 in 35 (46%), 1 in 22 (29%), 2 in 8 (11%), and 3 in 11 (14%). The neointimal thickness increased significantly with increasing neointimal coverage grade on angioscopy. Neointimal color was graded as white in 40 (53%) and yellow in 36 segments (47%). Histological analysis revealed that yellow neointima contained fibroatheroma, foam cells accumulation or superficial calcium deposition. A thrombus was identified in 13 segments. Thrombi adherent around the stent strut were partly intimal erythrocyte accumulation around the strut. </p><p><b><i>Conclusions: </i></b>In-stent yellow segment had atherosclerotic components. CAS could evaluate vascular status comprehensively after DES implantation. </p>

Journal

  • Circulation Journal

    Circulation Journal 83(1), 193-197, 2018

    The Japanese Circulation Society

Codes

  • NII Article ID (NAID)
    130007550424
  • NII NACSIS-CAT ID (NCID)
    AA11591968
  • Text Lang
    ENG
  • ISSN
    1346-9843
  • NDL Article ID
    029414270
  • NDL Call No.
    Z54-B860
  • Data Source
    NDL  J-STAGE 
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