Clinical research

DOI: 10.4244/EIJ-D-22-00615

Prevalence and patterns of in-stent neoatherosclerosis in lower extremity artery disease

Arne Müller1, MD; Christian Bradaric1, MD; Andre Kafka1, MD; Michael Joner2,3, MD; Salvatore Cassese2, MD, PhD; Erion Xhepa2, MD; Sebastian Kufner2, MD; Adnan Kastrati2,3, MD; Karl-Ludwig Laugwitz1,3, MD; Tareq Ibrahim1, MD; Tobias Koppara1,3, MD

Abstract

Background: In-stent restenosis (ISR) is responsible for a rapid decline of vessel patency after stenting. To date, little is known about the role of in-stent neoatherosclerosis (NA) in stent failure in lower limb arteries.

Aims: This study aimed to determine the prevalence and patterns of in-stent NA in patients with symptomatic ISR of the lower extremity vasculature using intravascular optical coherence tomography (OCT) imaging.

Methods: Patients underwent endovascular revascularisation for ISR including angiography and OCT imaging. NA was defined as the presence of at least 1 fibroatheroma or fibrocalcific plaque within the neointima of a stented segment.

Results: Using OCT, we imaged 24 symptomatic patients with lower extremity artery disease (LEAD), with a total of 30 ISR in the lower limbs, prior to their scheduled endovascular interventions. NA formation was observed in 23 (76.7%) lesions, while all stents with an implant duration >5 years (n=8) showed signs of NA. The time from stent implantation to OCT was significantly increased in lesions with NA (p=0.002). Lesions without NA had a significantly shorter duration from index procedure to OCT than...

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Volume 18 Number 17
Apr 24, 2023
Volume 18 Number 17
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