In-stent neoatherosclerosis frequent after endovascular therapy in lower limb arteries

For this purpose, the patients underwent endovascular revascularisation for in-stent restenosis, including OCT imaging and angiography. In-stent neoatherosclerosis was defined as the presence of at least one fibroatheroma or fibrocalcific plaque within the neointima of a stented segment.

The researchers reported the following findings:

• Using OCT, the research team imaged 24 symptomatic patients with lower extremity artery disease (LEAD), with 30 ISR in the lower limbs, before their scheduled endovascular interventions.
• The formation of in-stent neoatherosclerosis was observed in 76.7% of lesions, while all stents with an implant duration > five years (n=8) showed signs of NA.
• The time from stent implantation to OCT was remarkably increased in lesions with NA.
• Lesions without neoatherosclerosis had a remarkably shorter duration from index procedure to OCT compared to those with ≥50 percent (n=9) or <50 percent (n=14) of frames exhibiting signs of NA.
• NA was predominantly characterized by fibroatheroma with thick fibrous caps with or without calcification.

"After endovascular therapy in lower limb arteries, in-stent neoatherosclerosis is frequently identified by OCT imaging; this increases both in extent and frequency the longer the duration since implantation," the researchers conclude. "Our results indicate an active atherosclerotic process that may require tailored mitigation strategies."

Reference:

The study "Prevalence and patterns of in-stent neoatherosclerosis in lower extremity artery disease" appeared in the EuroIntervention, the official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI). DOI: 10.4244/EIJ-D-22-00615