Optical coherence tomography and histopathological assessment of delayed arterial healing after drug-eluting stent implant in a pig coronary model Daisuke.

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Optical coherence tomography and histopathological assessment of delayed arterial healing after drug-eluting stent implant in a pig coronary model Daisuke Matsumoto, Toshiro Shinke, Takamitsu Nakamura, Junya Shite, Jinsheng Li, Dongming Hou, Nicolas Chronos International Journal of Cardiology Volume 170, Issue 2, Pages 152-159 (December 2013) DOI: 10.1016/j.ijcard.2013.10.023 Copyright © 2013 Elsevier Ireland Ltd Terms and Conditions

Fig. 1 Representative images of BMS histology (Movat pentachrome staining, 20×) and OCT. International Journal of Cardiology 2013 170, 152-159DOI: (10.1016/j.ijcard.2013.10.023) Copyright © 2013 Elsevier Ireland Ltd Terms and Conditions

Fig. 2 Representative images of SES histology (Movat pentachrome staining, 20×) and OCT. International Journal of Cardiology 2013 170, 152-159DOI: (10.1016/j.ijcard.2013.10.023) Copyright © 2013 Elsevier Ireland Ltd Terms and Conditions

Fig. 3 Correlation between OCT and histology. Lumen area, intimal thickness, and %area stenosis were well correlated, but stent area and intimal area were poorly correlated. International Journal of Cardiology 2013 170, 152-159DOI: (10.1016/j.ijcard.2013.10.023) Copyright © 2013 Elsevier Ireland Ltd Terms and Conditions

Fig. 4 Representative OCT images (A, B, C) with schematic drawings (D, E, F) and histology images (hematoxylin–eosin, 20× G, H, I, 100× J, K, L). A: Layered type; concentric layers with an adluminal high signal layer and an abluminal low signal layer, B: Homo type; homogeneous with high signal uniform properties, and C: Hetero type; heterogeneous with focal multiple low signal properties. Low intensity area of OCT image of Layered type shows mixed immature and mature smooth muscle cells. Low intensity area of OCT image of Hetero type shows some inflammation and intramural thrombus. International Journal of Cardiology 2013 170, 152-159DOI: (10.1016/j.ijcard.2013.10.023) Copyright © 2013 Elsevier Ireland Ltd Terms and Conditions

Fig. 5 Relation between quantitative OCT assessment and OCT intensity (A) and histological findings (B,C). OCT intensity of Homo is higher than Layered and Hetero. Thrombus and inflammation of Hetero are higher than Homo and Layered. Layered: Layered type, Homo: Homogeneous with high signal type, Hetero: Heterogeneous with multiple low type. International Journal of Cardiology 2013 170, 152-159DOI: (10.1016/j.ijcard.2013.10.023) Copyright © 2013 Elsevier Ireland Ltd Terms and Conditions

Fig. 6 Distribution of three categories in BMS and SES. SES showed higher frequency of Hetero (Homo 16.7%, Layered 5.6%, Hetero 77.8%), while BMS revealed predominantly Homo (Homo 79.2%, Layered 12.5%, Hetero 8.3%, P<0.01 vs SES). International Journal of Cardiology 2013 170, 152-159DOI: (10.1016/j.ijcard.2013.10.023) Copyright © 2013 Elsevier Ireland Ltd Terms and Conditions

Fig. 7 Histological scoring in BMS and SES. Stocked column graph showing grading from 0 to 3 analyzed sections from each stent for inflammation and thrombus. Scoring differed significantly between BMS and SES (P<0.05). International Journal of Cardiology 2013 170, 152-159DOI: (10.1016/j.ijcard.2013.10.023) Copyright © 2013 Elsevier Ireland Ltd Terms and Conditions

Fig. 8 Percent diameter changes after acetylcholine infusion (5–10mm distal of reference segments). The endothelium-dependent vasodilatory response to acetylcholine (ACh) was diminished in SES compared with BMS (P=0.024). However, the endothelium-independent response to NTG was comparable for SES and BMS. NTG, nitroglycerin. International Journal of Cardiology 2013 170, 152-159DOI: (10.1016/j.ijcard.2013.10.023) Copyright © 2013 Elsevier Ireland Ltd Terms and Conditions

Fig. 9 Correlation between histological findings and % diameter change in response to acetylcholine infusion. International Journal of Cardiology 2013 170, 152-159DOI: (10.1016/j.ijcard.2013.10.023) Copyright © 2013 Elsevier Ireland Ltd Terms and Conditions