Previous studies have suggested that restenosis (RS) after stenting is mainly due to smooth muscle cell proliferation and migration, but recent evidence suggests that in-stent restenosis（ISR） is associated with a number of factors. Coronary artery calcification is an independent predictor of ischaemia-mediated revascularisation 1 year after percutaneous coronary intervention (PCI) following RS.The characteristics of new neointima in patients with in-stent restenosis of calcified lesions are important issues to explore
The characteristics of the endothelium after DES following implantation of calcified lesions have always been of interest to us. Its inherent peculiarities make the new endothelium of calcified lesions different. Firstly, the presence of calcification makes the neointima heal slowly. In addition DES has an anti-proliferative effect, which further diminishes the healing ability of the neointima of calcified lesions and impairs the barrier function of the endothelium. This may have a similar pathway to the formation of neointimal atherosclerosis or heterogeneous endothelium within the neointima. Secondly, stents with calcified lesions can be accompanied by incomplete stent expansion, stent fracture and stent misalignment. These conditions may accelerate the occurrence of restenosis within the stent. Thirdly, there are different types of calcified lesions. Different types of calcified lesions may heal and restenosis in different ways. It is therefore understood that calcified lesion healing has a number of pathways that exist in contradiction. These are issues that need to be explored in depth.
Study Type
OBSERVATIONAL
Enrollment
120
Calcification of atherosclerosis, a complex, organic, regulated and active process, is one of the manifestations of atherosclerosis. The progression of coronary atherosclerosis is a strong independent predictor of future coronary events. It has been shown that coronary artery calcification affects the healing of the neointima and the function of the endothelium after stenting. This may lead to changes in neointimal morphology and the development of neoatherosclerosis after stent implantation.
ShenyangNH
Shenyang, Liaoning, China
RECRUITINGMean lumen area
Quantitative Indicators，the mean area bounded by the luminal border on OCT（Optical Coherence Tomography）
Time frame: through study completion, an average of 1 year
Minimum lumen area
Quantitative Indicators，the minimum area bounded by the luminal border on OCT
Time frame: through study completion, an average of 1 year
Maximum lumen area
Quantitative Indicators，the maximum area bounded by the luminal border on OCT
Time frame: through study completion, an average of 1 year
Percent area stenosis
Quantitative Indicators，the (reference lumen area minus the minimum lumen area) divided by the reference lumen area, multiplied by 100. The reference segment used should be specified (proximal, distal, largest or average) on OCT
Time frame: through study completion, an average of 1 year
Mean stent area
Quantitative Indicators，the mean area bounded by the stent border on OCT
Time frame: through study completion, an average of 1 year
Minimum stent area
Quantitative Indicators，the Minimum area bounded by the stent border on OCT
Time frame: through study completion, an average of 1 year
Maximum stent area
Quantitative Indicators，the Maximum area bounded by the stent border on OCT
Time frame: through study completion, an average of 1 year
lipid-laden intima
Qualitative indicators,a diffusely bordered, signal-poor region with overlying signal-rich bands in the intima on OCT.the investigators measured its incidence on OCT.
Time frame: through study completion, an average of 1 year
Calcification
Qualitative indicators,shows a well-delineated, signal-poor region with sharp borders.the investigators measured its incidence on OCT.
Time frame: through study completion, an average of 1 year
Thrombi
Qualitative indicators,masses protruding into the lumen and discontinuous from the surface of the vessel wall.the investigators measured its incidence on OCT.
Time frame: through study completion, an average of 1 year
Intimal rupture
Qualitative indicators,discontinuity of the fibrous cap connecting the lumen.the investigators measured its incidence on OCT.
Time frame: through study completion, an average of 1 year
Neovascularization
Qualitative indicators,the presence of signal-poor holes or tubular structures with a diameter of 50 to 300 μm that are not connected to the vessel lumen.the investigators measured its incidence on OCT.
Time frame: through study completion, an average of 1 year
Thin-cap fibroatheroma (TCFA)
containing intima was defined as fibrous cap thickness ≤65 μm at the thinnest segment and an angle of lipid tissue ≥180°.the investigators measured its incidence on OCT.
Time frame: through study completion, an average of 1 year
Macrophage infiltration
Qualitative indicators,a bright spot with a high signal variance from the surrounding tissue.the investigators measured its incidence on OCT.
Time frame: through study completion, an average of 1 year
Stent underexpansion
Qualitative indicators,Stent expansion describes the minimum stent cross-sectional area either as an absolute measure (absolute expansion), or compared with the predefined reference area, which can be the proximal, distal, largest, or average reference area (relative expansion).the investigators measured its incidence on OCT.
Time frame: through study completion, an average of 1 year
stent fracture
Qualitative indicators,the interruption of stent continuity.the investigators measured its incidence on OCT.
Time frame: through study completion, an average of 1 year
Uncovered struts
the ratio of uncovered-to-total stent struts per section was calculated and expressed as percent on OCT.
Time frame: through study completion, an average of 1 year
neoatherosclerosis
neoatherosclerosis were defined by the presence of one or more of the following: lipid laden tissue ，thin-cap fibroatheroma (TCFA)，neointimal calcification，Macrophage infiltration.the investigators measured its incidence .
Time frame: through study completion, an average of 1 year
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