Author + information
- Masayasu Ikutomi,
- Kozo Okada,
- Kojiro Miki,
- Ryo Kameda,
- Fumiyuki Otsuka,
- Paul Yock,
- Peter Fitzgerald,
- Osami Kawarada and
- Yasuhiro Honda
Background: Chronic arterial injury can contribute to neointimal hyperplasia (NIH) and restenosis after stenting. This study aimed to investigate differential arterial responses to 3 new-generation self-expanding nitinol stents assessed by serial optical coherence tomography (OCT).
Methods: Legs of healthy swine randomly received either a Misago, Innova, or SMART Flex stent (n=6 for each, 6 × 60 mm) implanted at a tapered segment (distal superficial femoral to proximal popliteal artery) with no pre/post-dilatation. OCT was performed at baseline, post-stent, 4 weeks, and 13 weeks. In addition to standard variables, development of micro vessels within NIH and peri-strut low intensity area (PLIA) were assessed at every 5 mm.
Results: Overall, the degree of late stent enlargement significantly correlated with NIH at 13 weeks (p<0.001). Compared with other stents, Misago showed the lowest degree of late over-expansion particularly at the distal tapered segment, leading to the smallest NIH and largest lumen at 13 weeks. While the development of micro vessels was not related to NIH, PLIA detected at 4 weeks was associated with larger NIH at 13 weeks (P<0.0001). Axial distribution of PLIA also correlated with NIH distribution at 13 weeks (figure).
Conclusions: Late stent enlargement of self-expanding nitinol stents may cause a chronic stress on the arterial wall. PLIA may possibly reflect sustained arterial injury and/or inflammation, thereby predicting subsequent progression of neointimal hyperplasia.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Head to Toe: Outcomes of Endovascular Interventions
Abstract Category: 18. Interventional Cardiology: Carotid and Endovascular Intervention
Presentation Number: 1112-119
- 2017 American College of Cardiology Foundation