2013 Fiscal Year Final Research Report

Mechanism and prediction of restenosis after drug-eluting stent implantation in patients with hemodialysis

Research Project

Project/Area Number	23500536
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Research Field	Biomedical engineering/Biological material science
Research Institution	University of Occupational and Environmental Health, Japan
Principal Investigator	SONODA Shinjo 産業医科大学, 医学部, 講師 (90299610)
Co-Investigator(Kenkyū-buntansha)	OTSUJI Yutaka 産業医科大学, 医学部, 教授 (30264427) OKAZAKI Masahiro 産業医科大学, 医学部, 准教授 (40233316)
Project Period (FY)	2011 – 2013
Keywords	血液透析 / 冠動脈治療 / イメージング / 炎症マーカー / 再狭窄
Research Abstract	We examined 423 consecutive patients to treat with drug-eluting stents (DES) with intravascular ultrasound (IVUS) guidance. Serial IVUS analysis was performed after stenting and at 8 months follow-up in hemodialysis patients (N=15, 1st Generation DES, D1=7, 2nd Generation DES, D2=8). Tissue characterization of neointima and plaque outside stent struts were performed using integrated backscatter IVUS. Instent restenosis occurred in each 1 patient. Neointima was mainly composed of fibrous tissue in each group (D1: 54%, D2:55%). Plaque outside stent struts increased in D1 (9%, mainly lipidic tissue), decreased in D2 (2%) at follow-up. Inflammation markers (CRP and PTX-3) were high at baseline, but did not associate with instent restenosis in both groups. In conclusion, both DES showed similar outcome in restenosis. However, D2 showed favorable effects on plaque outside stent struts without positive vessel remodeling.