In-stent tissue characteristics detected by optical coherence tomography may affect re-restenosis after cutting balloon angioplasty for in-stent restenosis

Abstract

Purpose: Cutting balloon angioplasty (CBA) is one of proposed treatments for in-stent restenosis (ISR) but re-restenosis rate after CBA is relatively high. In this study, we investigated whether optical coherence tomography (OCT) detected tissue characteristics can affect re-restenosis after CBA for ISR. Methods: Seventy consecutive patients with ISR who received OCT-guided CBA were enrolled. We divided our patients into TLR group in whom we performed target lesion revascuralization (TLR) for re-restenosis over 3 months after CBA for ISR and non-TLR group in whom we didn't perform TLR. We compared the incidence of drug-eluting stent, phase of ISR, ISR pattern, balloon size, maximal inflation pressure and the OCT parameters of ISR before CBA including restenotic tissue structure/backscatter, microvessels, thrombus and minimum lumen area between the two groups. Results: The rate of TLR was 21.4%. The incidence of microvessels, thrombus and heterogeneous or layered pattern in TLR group (n=15) was significantly higher than non-TLR group (n=55) while the other parameters showed non-significant differences (table). View this table: Table 1 Conclusions: The incidence of microvessels, thrombus and heterogeneous or layered pattern in ISR tissue detected by OCT may affect re-restenosis after CBA for ISR.