Clinical profile and optical coherence tomography based morphological characteristics of coronary in-stent restenosis: A cross-sectional study

IF 2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Indian heart journal Pub Date : 2026-03-01 Epub Date: 2025-11-04 DOI:10.1016/j.ihj.2025.10.007

Arihant Sharma, Shreya Gupta, Ranjit K. Nath, Ankit Aggarwal, Shivani Rao, Puneet Aggarwal, B.N. Pandit

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引用次数: 0

Abstract

Background

In-stent restenosis (ISR), a complication after percutaneous coronary intervention (PCI), involves neointimal hyperplasia and neoatherosclerosis. With the rise of drug-eluting stents (DES), Optical Coherence Tomography (OCT) has become essential for evaluating ISR morphology and guiding treatment decisions.

Objectives

This study aimed to investigate the morphological patterns and clinical features of ISR in an Indian cohort using OCT, identify common morphological characteristics, and explore their relationship with ISR duration.

Methods

A cross-sectional observational study at a tertiary care center in New Delhi included 50 patients with angiographically confirmed ISR. OCT was used to assess qualitative and quantitative parameters of restenotic lesions, including neointimal patterns, minimal lumen area (MLA), minimal stent area (MSA), lipid content, and calcium burden. The correlation between ISR duration (early vs. late) and OCT features was also analyzed.

Results

The mean age was 58.08 ± 9.68 years, with 74 % male participants. Most patients (80 %) had late ISR. Hypertension (66 %) and diabetes (44 %) were the most common comorbidities, and chronic stable angina was the most frequent presentation (60 %). OCT findings showed heterogeneous neointima in 64 %, stent under-expansion in 42 %, and calcification in 82 %. Late ISR had a significantly larger neointimal area, though no other features correlated significantly with ISR duration.

Conclusions

Neoatherosclerosis, especially heterogeneous neointima, is the primary morphological cause of ISR in this cohort. Stent under-expansion is a key contributor. OCT is valuable for diagnosing and planning ISR interventions. Larger studies are needed for broader conclusions and standardized management.

查看原文本刊更多论文

冠状动脉支架内再狭窄的临床特征和基于光学相干断层扫描的形态学特征：一项横断面研究。

背景：支架内再狭窄（ISR）是经皮冠状动脉介入治疗（PCI）后的并发症，涉及内膜增生和新动脉粥样硬化。随着药物洗脱支架（DES）的兴起，光学相干断层扫描（OCT）已成为评估ISR形态学和指导治疗决策的必要手段。目的：本研究旨在利用OCT研究印度队列中ISR的形态学模式和临床特征，确定共同的形态学特征，并探讨它们与ISR持续时间的关系。方法：在新德里的一家三级保健中心进行横断面观察研究，包括50例血管造影证实的ISR患者。OCT用于评估再狭窄病变的定性和定量参数，包括内膜模式、最小管腔面积（MLA）、最小支架面积（MSA）、脂质含量和钙负荷。我们还分析了ISR持续时间（早期和晚期）与OCT特征的相关性。结果：平均年龄58.08±9.68岁，男性占74%。大多数患者（80%）为晚期ISR。高血压（66%）和糖尿病（44%）是最常见的合并症，慢性稳定型心绞痛是最常见的表现（60%）。OCT显示异质新生内膜占64%，支架扩张不足占42%，钙化占82%。晚期ISR有明显较大的内膜面积，但没有其他特征与ISR持续时间显著相关。结论：新动脉粥样硬化，尤其是异质性新内膜，是该队列中ISR的主要形态学原因。支架扩张不足是一个关键因素。OCT对ISR干预的诊断和计划是有价值的。为了得到更广泛的结论和标准化的管理，需要进行更大规模的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Indian heart journal CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.60

自引率

6.70%

发文量

审稿时长

52 days

期刊介绍： Indian Heart Journal (IHJ) is the official peer-reviewed open access journal of Cardiological Society of India and accepts articles for publication from across the globe. The journal aims to promote high quality research and serve as a platform for dissemination of scientific information in cardiology with particular focus on South Asia. The journal aims to publish cutting edge research in the field of clinical as well as non-clinical cardiology - including cardiovascular medicine and surgery. Some of the topics covered are Heart Failure, Coronary Artery Disease, Hypertension, Interventional Cardiology, Cardiac Surgery, Valvular Heart Disease, Pulmonary Hypertension and Infective Endocarditis. IHJ open access invites original research articles, research briefs, perspective, case reports, case vignette, cardiovascular images, cardiovascular graphics, research letters, correspondence, reader forum, and interesting photographs, for publication. IHJ open access also publishes theme-based special issues and abstracts of papers presented at the annual conference of the Cardiological Society of India.