Background
Drug-eluting stents (DES) effectively reduce restenosis compared to bare metal stents (BMS). However, late stent thrombosis associated with DES is a major drawback of this device. Intimal plaque composition within DES may be one of the perpetrators for this. This study aimed to examine whether virtual histology intravascular ultrasound (VH-IVUS) can distinguish between plaque compositions of BMS vs. DES
Methods
We studied the 35 stents (including 19 overlapped stents which were treated as one long stent) in 27 patients with stable coronary artery disease who underwent coronary angiography and VH-IVUS in chronic phase after stent implantation. Stents were divided into two groups: DES ( n =22) and BMS ( n =13). In IVUS measurement, we contoured just outside of stent strut and lumen. The proportion of different components was calculated: necrotic core (NC), fibro-fatty, fibrosis, dense calcium. Thin-cap fibroatheroma in stent (in-stent TCFA) was defined as a NC >10% of the plaque area with a plaque burden of >40% only in stent area, as well as NC in contact with the lumen.
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