Effect of drug-coated balloon angioplasty on in-stent restenotic coronary lesions analyzed with optical coherence tomography and serial coronary artery angioscopy

Naotaka Akutsu; Akihito Ogaku; Yutaka Koyama; Hidesato Fujito; Yasunari Ebuchi; Suguru Migita; Tomoyuki Morikawa; Takehiro Tamaki; Takashi Mineki; Takaaki Kougo; Keisuke Kojima; Korehito Iida; Nobuhiro Murata; Toshihiko Nishida; Toru Oshima; Mitsumasa Sudo; Daisuke Kitano; Hironori Haruta; Daisuke Fukamachi; Tadateru Takayama; Takafumi Hiro; Atsushi Hirayama; Yasuo Okumura

doi:10.1007/s00380-019-01447-5

Effect of drug-coated balloon angioplasty on in-stent restenotic coronary lesions analyzed with optical coherence tomography and serial coronary artery angioscopy

Naotaka Akutsu, Akihito Ogaku, Yutaka Koyama, Hidesato Fujito, Yasunari Ebuchi, Suguru Migita, Tomoyuki Morikawa, Takehiro Tamaki, Takashi Mineki, Takaaki Kougo, Keisuke Kojima, Korehito Iida, Nobuhiro Murata, Toshihiko Nishida, Toru Oshima, Mitsumasa Sudo, Daisuke Kitano, Hironori Haruta, Daisuke Fukamachi, Tadateru TakayamaTakafumi Hiro, Atsushi Hirayama, Yasuo Okumura

School of Medicine

Nihon University

Research output: Contribution to journal › Article › peer-review

4 Citations (Scopus)

Abstract

Drug-coated balloon angioplasty (DCBA) has been recognized for its utility in preventing in-stent re-restenosis (ISR); however, imaging of the neointima immediately after treatment and during follow-up has only been described in a few case reports. This study aimed to determine the efficacy and mechanism of the DCBA using imaging studies both immediately after the DCBA and during the follow-up period. We enrolled 15 consecutive patients who underwent DCBA for in-stent restenosis (ISR). The in-stent neointimal volume was evaluated using optical coherence tomography (OCT), and the in-stent yellow grade was assessed using coronary angioscopy (CAS) immediately after DCBA and during the median follow-up period of 9 (8–15) months. The neointimal volume was significantly reduced from 77.1 ± 36.2 mm³ at baseline to 60.2 ± 23.9 mm³ immediately after DCBA (p = 0.0012 vs. baseline) and to 46.7 ± 21.9 mm³ during the follow-up (p = 0.0002 vs. post DCBA). The yellow grade of the residual plaques at the ISR lesion, which indicated plaque vulnerability, was significantly decreased in the follow-up CAG (from baseline: 1.79 ± 1.03, during the follow-up: 0.76 ± 0.82; p < 0.0001). These data suggest that DCBA may inhibit neointimal formation and provide angioscopic intimal stabilization for ISR lesions.

Original language	English
Pages (from-to)	1925-1935
Number of pages	11
Journal	Heart and Vessels
Volume	34
Issue number	12
DOIs	https://doi.org/10.1007/s00380-019-01447-5
Publication status	Published - 1 Dec 2019

Keywords

Coronary angioscopy
Drug-coated balloon
In-stent restenosis
Optical coherence tomography

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10.1007/s00380-019-01447-5

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Akutsu, N., Ogaku, A., Koyama, Y., Fujito, H., Ebuchi, Y., Migita, S., Morikawa, T., Tamaki, T., Mineki, T., Kougo, T., Kojima, K., Iida, K., Murata, N., Nishida, T., Oshima, T., Sudo, M., Kitano, D., Haruta, H., Fukamachi, D., ... Okumura, Y. (2019). Effect of drug-coated balloon angioplasty on in-stent restenotic coronary lesions analyzed with optical coherence tomography and serial coronary artery angioscopy. Heart and Vessels, 34(12), 1925-1935. https://doi.org/10.1007/s00380-019-01447-5

@article{ef1b754050054379ae7cc65eef012b0e,

title = "Effect of drug-coated balloon angioplasty on in-stent restenotic coronary lesions analyzed with optical coherence tomography and serial coronary artery angioscopy",

abstract = "Drug-coated balloon angioplasty (DCBA) has been recognized for its utility in preventing in-stent re-restenosis (ISR); however, imaging of the neointima immediately after treatment and during follow-up has only been described in a few case reports. This study aimed to determine the efficacy and mechanism of the DCBA using imaging studies both immediately after the DCBA and during the follow-up period. We enrolled 15 consecutive patients who underwent DCBA for in-stent restenosis (ISR). The in-stent neointimal volume was evaluated using optical coherence tomography (OCT), and the in-stent yellow grade was assessed using coronary angioscopy (CAS) immediately after DCBA and during the median follow-up period of 9 (8–15) months. The neointimal volume was significantly reduced from 77.1 ± 36.2 mm3 at baseline to 60.2 ± 23.9 mm3 immediately after DCBA (p = 0.0012 vs. baseline) and to 46.7 ± 21.9 mm3 during the follow-up (p = 0.0002 vs. post DCBA). The yellow grade of the residual plaques at the ISR lesion, which indicated plaque vulnerability, was significantly decreased in the follow-up CAG (from baseline: 1.79 ± 1.03, during the follow-up: 0.76 ± 0.82; p < 0.0001). These data suggest that DCBA may inhibit neointimal formation and provide angioscopic intimal stabilization for ISR lesions.",

keywords = "Coronary angioscopy, Drug-coated balloon, In-stent restenosis, Optical coherence tomography",

author = "Naotaka Akutsu and Akihito Ogaku and Yutaka Koyama and Hidesato Fujito and Yasunari Ebuchi and Suguru Migita and Tomoyuki Morikawa and Takehiro Tamaki and Takashi Mineki and Takaaki Kougo and Keisuke Kojima and Korehito Iida and Nobuhiro Murata and Toshihiko Nishida and Toru Oshima and Mitsumasa Sudo and Daisuke Kitano and Hironori Haruta and Daisuke Fukamachi and Tadateru Takayama and Takafumi Hiro and Atsushi Hirayama and Yasuo Okumura",

note = "Publisher Copyright: {\textcopyright} 2019, Springer Japan KK, part of Springer Nature.",

year = "2019",

month = dec,

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doi = "10.1007/s00380-019-01447-5",

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Akutsu, N, Ogaku, A, Koyama, Y, Fujito, H, Ebuchi, Y, Migita, S, Morikawa, T, Tamaki, T, Mineki, T, Kougo, T, Kojima, K, Iida, K, Murata, N, Nishida, T, Oshima, T, Sudo, M, Kitano, D, Haruta, H, Fukamachi, D, Takayama, T, Hiro, T, Hirayama, A & Okumura, Y 2019, 'Effect of drug-coated balloon angioplasty on in-stent restenotic coronary lesions analyzed with optical coherence tomography and serial coronary artery angioscopy', Heart and Vessels, vol. 34, no. 12, pp. 1925-1935. https://doi.org/10.1007/s00380-019-01447-5

TY - JOUR

T1 - Effect of drug-coated balloon angioplasty on in-stent restenotic coronary lesions analyzed with optical coherence tomography and serial coronary artery angioscopy

AU - Akutsu, Naotaka

AU - Ogaku, Akihito

AU - Koyama, Yutaka

AU - Fujito, Hidesato

AU - Ebuchi, Yasunari

AU - Migita, Suguru

AU - Morikawa, Tomoyuki

AU - Tamaki, Takehiro

AU - Mineki, Takashi

AU - Kougo, Takaaki

AU - Kojima, Keisuke

AU - Iida, Korehito

AU - Murata, Nobuhiro

AU - Nishida, Toshihiko

AU - Oshima, Toru

AU - Sudo, Mitsumasa

AU - Kitano, Daisuke

AU - Haruta, Hironori

AU - Fukamachi, Daisuke

AU - Takayama, Tadateru

AU - Hiro, Takafumi

AU - Hirayama, Atsushi

AU - Okumura, Yasuo

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Drug-coated balloon angioplasty (DCBA) has been recognized for its utility in preventing in-stent re-restenosis (ISR); however, imaging of the neointima immediately after treatment and during follow-up has only been described in a few case reports. This study aimed to determine the efficacy and mechanism of the DCBA using imaging studies both immediately after the DCBA and during the follow-up period. We enrolled 15 consecutive patients who underwent DCBA for in-stent restenosis (ISR). The in-stent neointimal volume was evaluated using optical coherence tomography (OCT), and the in-stent yellow grade was assessed using coronary angioscopy (CAS) immediately after DCBA and during the median follow-up period of 9 (8–15) months. The neointimal volume was significantly reduced from 77.1 ± 36.2 mm3 at baseline to 60.2 ± 23.9 mm3 immediately after DCBA (p = 0.0012 vs. baseline) and to 46.7 ± 21.9 mm3 during the follow-up (p = 0.0002 vs. post DCBA). The yellow grade of the residual plaques at the ISR lesion, which indicated plaque vulnerability, was significantly decreased in the follow-up CAG (from baseline: 1.79 ± 1.03, during the follow-up: 0.76 ± 0.82; p < 0.0001). These data suggest that DCBA may inhibit neointimal formation and provide angioscopic intimal stabilization for ISR lesions.

AB - Drug-coated balloon angioplasty (DCBA) has been recognized for its utility in preventing in-stent re-restenosis (ISR); however, imaging of the neointima immediately after treatment and during follow-up has only been described in a few case reports. This study aimed to determine the efficacy and mechanism of the DCBA using imaging studies both immediately after the DCBA and during the follow-up period. We enrolled 15 consecutive patients who underwent DCBA for in-stent restenosis (ISR). The in-stent neointimal volume was evaluated using optical coherence tomography (OCT), and the in-stent yellow grade was assessed using coronary angioscopy (CAS) immediately after DCBA and during the median follow-up period of 9 (8–15) months. The neointimal volume was significantly reduced from 77.1 ± 36.2 mm3 at baseline to 60.2 ± 23.9 mm3 immediately after DCBA (p = 0.0012 vs. baseline) and to 46.7 ± 21.9 mm3 during the follow-up (p = 0.0002 vs. post DCBA). The yellow grade of the residual plaques at the ISR lesion, which indicated plaque vulnerability, was significantly decreased in the follow-up CAG (from baseline: 1.79 ± 1.03, during the follow-up: 0.76 ± 0.82; p < 0.0001). These data suggest that DCBA may inhibit neointimal formation and provide angioscopic intimal stabilization for ISR lesions.

KW - Coronary angioscopy

KW - Drug-coated balloon

KW - In-stent restenosis

KW - Optical coherence tomography

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U2 - 10.1007/s00380-019-01447-5

DO - 10.1007/s00380-019-01447-5

M3 - Article

C2 - 31203393

AN - SCOPUS:85067658264

SN - 0910-8327

VL - 34

SP - 1925

EP - 1935

JO - Heart and Vessels

JF - Heart and Vessels

IS - 12

ER -

Effect of drug-coated balloon angioplasty on in-stent restenotic coronary lesions analyzed with optical coherence tomography and serial coronary artery angioscopy

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Keywords

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