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Heart and Vessels

, Volume 34, Issue 12, pp 1925–1935 | Cite as

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 OkumuraEmail author
Original Article
  • 97 Downloads

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

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

Notes

Acknowledgements

The authors would like to extend their sincere appreciation to Professor Atsushi Hirayama for guidance and valuable suggestions during the research, to Professor Yasuo Okumura and Professor Tadateru Takayama for their direct guidance during the research. Furthermore, we would like to express our gratitude to the catheter room of Nihon University Itabashi Hospital, who always cooperated at the clinical site of the research.

Compliance with ethical standards

Conflict of interest

Dr. Hirayama A and Hiro T are employed by the Department of Advanced Cardiovascular Imaging, Nihon University School of Medicine; which is endowed by Boston Scientific Corporation Japan, Abbott Medical Japan Co., Ltd and St. Jude Medical Japan Co., Ltd.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study and its protocols were approved by the Institutional Review Board of Nihon University Itabashi Hospital. This article does not contain any studies with animals performed by any of the authors.

References

  1. 1.
    Radke PW, Koiser A, Frost C, Sigwart U (2003) Outcome after treatment of coronary in-stent restenosis; results from a systematic review using meta-analysis techniques. Eur Heart J 24:266–273CrossRefGoogle Scholar
  2. 2.
    Unverdorben M, Vallbracht C, Cremers B, Heuer H, Hengstenberg C, Maikowski C, Werner GS, Antoni D, Kleber FX, Bocksch W, Leschke M, Ackermann H, Boxberger M, Speck U, Degenhardt R, Scheller B (2015) Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the treatment of coronary in-stent restenosis: the three-year results of the PEPCAD  II ISR study. EuroIntervention 11(8):926–934CrossRefGoogle Scholar
  3. 3.
    Wöhrle J, Zadura M, Möbius-Winkler S, Leschke M, Opitz C, Ahmed W, Barragan P, Simon JP, Cassel G, Scheller B (2012) SeQuentPlease World Wide Registry: clinical results of SeQuentPlease paclitaxel-coated balloon angioplasty in a large-scale, prospective registry study. J Am Coll Cardiol. 60:1733–1738CrossRefGoogle Scholar
  4. 4.
    Auffret V, Berland J, Barragan P, Waliszerwski M, Bonello L, Delarche N, Furber A, Albert F, Carrié D, Eltchaninoff H, Pansieri M, Schneeberger M, Piot C, Marcollet P, Bedossa M (2016) Treatment of drug-eluting stents in-stent restenosis with paclitaxel-coated balloon angioplasty: Insights from the French "real-world" prospective GARO Registry. Int J Cardiol 203:690–696CrossRefGoogle Scholar
  5. 5.
    Rittger H, Waliszewski M, Brachmann J, Hohenforst-Schmidt W, Ohlow M, Brugger A, Thiele H, Birkemeyer R, Kurowski V, Schlundt C, Zimmermann S, Lonke S, von Cranach M, Markovic S, Daniel WG, Achenbach S, Wöhrle J (2015) Long-term outcomes after treatment with a paclitaxel-coated balloon versus balloon angioplasty: Insights from the PEPCAD-DES Study (treatment of drug-eluting stent [DES] in-stent restenosis with SeQuent please paclitaxel-coated percutaneous transluminal coronary angioplasty [PTCA] catheter). JACC Cardiovasc Interv 8:1695–1700CrossRefGoogle Scholar
  6. 6.
    Unverdorben M, Vallbracht C, Cremers B, Heuer H, Hengstenberg C, Maikowski C, Werner GS, Antoni D, Kleber FX, Bocksch W, Leschke M, Ackermann H, Boxberger M, Speck U, Degenhardt R, Scheller B (2015) Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the treatment of coronary in-stent restenosis: the three-year results of the PEPCAD II ISR study. EuroIntervention 11:926–934CrossRefGoogle Scholar
  7. 7.
    Murata N, Takayama T, Hiro T (2017) Serial observations of in-stent restenosis treated with drug-coated balloon angioplasty by optical coference tomography and coronary angioscopy. Int Heart J. 58:134–139CrossRefGoogle Scholar
  8. 8.
    Tada T, Kadota K, Hosogi S, Miyake K, Amano H, Nakamura M, Izawa Y, Kubo S, Ichinohe T, Hyoudou Y, Eguchi H, Otsuru S, Hasegawa D, Shigemoto Y, Habara S, Tanaka H, Fuku Y, Kato H, Goto T, Mitsudo K (2014) Association between tissue characteristics evaluated with optical coherence tomography and mid-term results after paclitaxel-coated balloon dilatation for in-stent restenosis lesions: a comparison with plain old balloon angioplasty. Eur Heart J Cardiovasc Imaging 15:307–315CrossRefGoogle Scholar
  9. 9.
    Mehran R, Dangas G, Abizaid AS, Mintz GS, Lansky AJ, Satler LF, Pichard AD, Kent KM, Stone GW, Leon MB (1999) Angiographic patterns of in-stent restenosis: classifyion and implications for lomg-term outcome. Circulation 100:1872–1878CrossRefGoogle Scholar
  10. 10.
    Mehanna EA, Attizzani GF, Kyono H, Hake M, Bezerra HG (2011) Aessessment of coronary stent by optical coherence tomography, methodology and definitions. Int J Cardiovasc Imaging 27:259–269CrossRefGoogle Scholar
  11. 11.
    Hirayama A, Saito S, Ueda Y, Takayama T, Honye J, Komatsu S, Yamaguchi O, Li Y, Yajima J, Nanto S, Takazawa K, Kodama K (2009) Qualitative and quantitative changes in coronary plaque associated with atorvastatin therapy. Circ J 73:718–725CrossRefGoogle Scholar
  12. 12.
    Ueda Y, Asakura M, Yamaguchi O, Hirayama A, Hori M, Kodama K (2001) The healing processs of infarct-related plaques: insights from 18 months of serial angioscopic follow-up. J Am Coll Cardiol 38:1916–1922CrossRefGoogle Scholar
  13. 13.
    Gonzalo N, Serruys PW, Okamura T, van Beusekom HM, Garcia HM, van Soest G, van der Giessen W, Regar E (2009) Optical coherence tomogramphy patterns of stent restenosis. Am Heart J 158:284–293CrossRefGoogle Scholar
  14. 14.
    Tanimoto S, Aoki J, Serruys PW, Regar E (2006) Paclitaxel-eluting stent restenosis shows three-layer appearance by optical coherence tomogramphy. Eurointervention 1:484PubMedGoogle Scholar
  15. 15.
    Masawa T, Abe S, Toyoda S, Sakuma M, Nasuno T, Kageyama M, Tokura M, Koizumi S, Taguchi I, Inoue T (2016) Comparison of the performance of zotarolimus- and everolimus-eluting stents by optical coherence tomography and coronary angioscopy. Heart Vessels 31:1230–1238CrossRefGoogle Scholar
  16. 16.
    Kodama K, Komatsu S, Ueda Y, Takayama T, Yajima J, Nanto S, Matsuoka H, Saito S, Hirayama A (2010) Stabilization and regression of coronary plaques treated with pitavastatin proven by angioscopy and intravascular ultrasound—the TOGETHER trial. Circ J 74:1922–1928CrossRefGoogle Scholar
  17. 17.
    Scheller B, Clever YP, Kelsh B, Hehrlein C, Bocksch W, Rutsch W, Haghi D, Dietz U, Speck U, Böhm M, Cremers B (2012) Long-term follow-up after treatment of coronary in-stent restenosis with a paclitaxel-coated balloon catheter. JACC Cardiovasc Interv 5:323–330CrossRefGoogle Scholar
  18. 18.
    Unverdorben M, Vallbracht C, Cremers B, Heuer H, Hengstenberg C, Maikowski C, Werner GS, Antoni D, Kleber FX, Bocksch W, Leschke M, Ackermann H, Boxberger M, Speck U, Degenhardt R, Scheller B (2015) Paclitaxel-coated balloon catheter versus paclitaxel-coated stent for the treatment of coronary in-stent restenosis: the three-year results of the PEPCAD  II ISR study. EuroIntervention 11:926–934CrossRefGoogle Scholar
  19. 19.
    Rittger H, Brachmann J, Sinha AM, Waliszewski M, Ohlow M, Brugger A, Thiele H, Birkemever R, Kurowski V, Breithardt OA, Schmidt M, Zimmermann S, Lonke S, von Cranach M, Nguyen TV, Daniel WG, Wöhrle J (2012) A randomized, multicenter, single-blinded trial comparing paclitaxel-coated balloon angioplasty with plain balloon angioplasty in drug-eluting stent restenosis: the PEPCAD-DES study. J Am Coll Cardiol 59:1377–1382CrossRefGoogle Scholar
  20. 20.
    Caplow M, Shanks J, Ruhlen R (1994) How taxol modulates microtubule disassembly. J Biol Chem 269:23399–23402PubMedGoogle Scholar
  21. 21.
    Bhat N, Perera PY, Carboni JM, Blanco J, Golenbock DT, Mayadas TN, Vogel SN (1999) Use of a photoactivatable taxol analog to identify unique cellular targets in murine macrophages: identification of murine CD18 as a major taxol-binding protein and a role of Mac-1 in taxol-induced gene expression. J Immunol 162:7335–7342PubMedGoogle Scholar
  22. 22.
    Jun CD, Choi BM, Kim HM, Chung HT (1995) Involvement of protein kinase C during taxol-induced activation of murine peritoneal macrophages. J Immunol 154:6541–6547PubMedGoogle Scholar
  23. 23.
    Tada T, Kadota K, Hosogi S, Miyakw K, Ohya M, Amano H, Izawa Y, Kanazawa T, Kubo S, Ichinohe T, Hyoudou Y, Hayakawa Y, Sabbah MM, Otsuru S, Hasegawa D, Habara S, Tanaka H, Fuku Y, Katoh H, Goto T, Mitsudo K (2015) Association between tissue characteristics assessed with optical coherence tomography and mid-term results after percutaneous coronary intervenetion for in-stent restenosis lesions: a compareson between balloon angioplasty, paclitaxel-coated balloon dilatation, and drug-eluting stent implantation. Eur Heart J Cardiovasc Imaging 16:1101–1111CrossRefGoogle Scholar
  24. 24.
    Shibuya M, Ishihara M (2016) Coronary angioscopy for the evaluation of vessel response after drug-eluting stent implantation. Circ J 80:590–591CrossRefGoogle Scholar
  25. 25.
    Ishihara T, Awata M, Sera F, Fujita M, Watanabe T, Iida O, Ishida Y, Nanto S, Uematsu M (2013) Arterial repair 4 months after zotarolimus-eluting stent implantation observed on angioscopy. Circ J 77:1186–1192CrossRefGoogle Scholar
  26. 26.
    Sotomi Y, Suzuki S, Kobayashi T, Hamanaka Y, Nakatani S, Hirata A, Takeda Y, Ueda Y, Sakata Y, Higuchi Y (2018) Impact of the 1-year angioscopic findings on long-term clinical events in 504 patients treated with first-generation or second generation drug-eluting stents : the DESNOTE-X study. EuroIntervention.  https://doi.org/10.4244/EIJ-D-18-00660 CrossRefPubMedGoogle Scholar
  27. 27.
    Takayama T, Hiro T, Ueda Y, Honye J, Komatsu S, Yamaguchi O, Li Y, Yajima J, Takazawa K, Nanto S, Saito S, Hirayama A, Kodama K (2013) Plaque stabilization by intensive LDL-cholesterol lowering therapy with atorvastatin is delayed in type 2 diabetic patients with coronary artery disease-Serial angioscopic and intravascular ultrasound analysis. J Cardiol 61:381–386CrossRefGoogle Scholar
  28. 28.
    Suzuki T, Suzuki T, Hosokawa H (1998) Comparison of the restenosismechanism of cutting balloon angioplasty and plain old balloon angioplasty: a serial intravascular ultrasound study (abstract) J Am Coll Cardiol 31: 498.Google Scholar
  29. 29.
    Tsukahara R, Muramatsu T, Akimoto N (1996) Mechanism of acute gain and late loss operating in angioplasty with a cutting balloon as evaluated by intravascular ultrasonography. Jpn J Interv Cardiol 11:439–442Google Scholar

Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Naotaka Akutsu
    • 1
  • Akihito Ogaku
    • 1
  • Yutaka Koyama
    • 1
  • Hidesato Fujito
    • 1
  • Yasunari Ebuchi
    • 1
  • Suguru Migita
    • 1
  • Tomoyuki Morikawa
    • 1
  • Takehiro Tamaki
    • 1
  • Takashi Mineki
    • 1
  • Takaaki Kougo
    • 1
  • Keisuke Kojima
    • 1
  • Korehito Iida
    • 1
  • Nobuhiro Murata
    • 1
  • Toshihiko Nishida
    • 1
  • Toru Oshima
    • 1
  • Mitsumasa Sudo
    • 1
    • 2
  • Daisuke Kitano
    • 1
    • 2
  • Hironori Haruta
    • 1
  • Daisuke Fukamachi
    • 1
  • Tadateru Takayama
    • 3
  • Takafumi Hiro
    • 1
    • 2
  • Atsushi Hirayama
    • 1
  • Yasuo Okumura
    • 1
    Email author
  1. 1.Division of Cardiology, Department of MedicineNihon University School of MedicineTokyoJapan
  2. 2.Division of Advanced Cardiovascular Imaging, Department of MedicineNihon University School of MedicineTokyoJapan
  3. 3.Department of General MedicineNihon University School of MedicineTokyoJapan

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