Intravascular Imaging for Guiding In-Stent Restenosis and Stent Thrombosis Therapy

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Erdogan E., Bajaj R., Lansky A., Mathur A., Baumbach A., Bourantas C.

JOURNAL OF THE AMERICAN HEART ASSOCIATION, cilt.11, sa.22, 2022 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 11 Sayı: 22
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1161/jaha.122.026492
  • Dergi Adı: JOURNAL OF THE AMERICAN HEART ASSOCIATION
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, CINAHL, EMBASE, MEDLINE, Veterinary Science Database, Directory of Open Access Journals
  • Anahtar Kelimeler: In-stent restenosis, intravascular ultrasound, optical coherence tomography, DRUG-ELUTING STENT, OPTICAL COHERENCE TOMOGRAPHY, PACLITAXEL-COATED BALLOON, PERCUTANEOUS CORONARY INTERVENTION, BARE-METAL STENTS, LOCAL HEMODYNAMIC FORCES, LONG-TERM OUTCOMES, CLINICAL-OUTCOMES, VASCULAR BRACHYTHERAPY, ROTATIONAL ATHERECTOMY
  • Van Yüzüncü Yıl Üniversitesi Adresli: Evet

Özet

Advances in stent technology and the design of endovascular devices with thinner struts, anti-inflammatory and antithrombotic polymers, and better drug kinetics have enhanced the safety and efficacy of the second-generation drug-eluting stents and broadened their use in the therapy of high-risk patients and complex anatomies. However, despite these developments, in-stent restenosis and stent thrombosis remain the Achilles' heel of percutaneous coronary intervention, with their cumulative incidence reaching up to 10% at 5 years following percutaneous coronary intervention. The treatment of stent failure poses challenges and is associated with a worse prognosis than conventional percutaneous coronary intervention. Several studies have recently highlighted the value of intravascular imaging in identifying causes of stent failure, underscored its role in treatment planning, and registries have shown that its use may be associated with better clinical outcomes. The present review aims to summarize the evidence in the field; it discusses the value of intravascular imaging in identifying the mechanisms of in-stent restenosis and stent thrombosis in assessing the morphological characteristics of neointima tissue that appears to determine long-term outcomes in evaluating procedural results, and presents the findings of studies supporting its value in guiding therapy in stent failure.