Key result
OCT identifies disrupted atherosclerotic neointima causing unstable symptoms 7 years after bare-metal stenting.
Why the study?
Neointima within bare-metal stents often transforms into atherosclerotic tissue over time, but the clinical implications of neointimal disruption remain unclear.
Case Report (n=1)
No
OCT imaging can identify disruption of atherosclerotic neointima years after bare metal stent implantation, providing insight into the pathogenesis of late acute coronary syndrome.
Answers are grounded in this paper and cite their sources.
Neointimal disruption over BMS may underlie late post-stent angina; leaves open prevalence and management implications.
A 58-year-old male with a history of prior myocardial infarction, hypertension, and dyslipidemia was admitted due to deteriorating exertional angina. A bare metal stent (Multilink plus™, GUIDANT Corporation, Santa Clara, CA, USA) had been implanted into the proximal left anterior descending artery because of ST-elevation myocardial infarction 7 years earlier. Optical coherence tomography (OCT) showed a disruption of the atherosclerotic neointima overlying the stent. Intravascular imaging studies and pathological studies have shown that neointima within a bare-metal stent often transform into atherosclerotic tissue during an extended period of time. In the current report, OCT demonstrated that a disruption of the atherosclerotic neointima has the potential to cause the development of unstable clinical features. OCT examinations therefore help to understand the pathogenesis of acute coronary syndrome after stent implantation.
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Inami et al. (2012) conducted a case report in In-stent restenosis / Neoatherosclerosis (n=1). Bare metal stent implantation (7 years prior) was evaluated on Optical coherence tomography (OCT) findings of the restenotic lesion. Optical coherence tomography demonstrated a disruption of the atherosclerotic neointima overlying a bare-metal stent 7 years after implantation, contributing to unstable clinical features.
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