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Evaluating neoatherosclerosis for risk stratification of very-late DES failure

Y Ueda, K Matsuo, Y Nishimoto, R Sugihara, Y Takeda, A Hirata, T Nemoto, M Okada, A Murakami, K Kashiwase & K Kodama

Drug-eluting stents (DESs) in comparison with bare metal stents (BMSs) have reduced early target lesion revascularization (TLR) through exerting an inhibitory effect n smooth muscle cell hyperplasia but have also increased the risk of stent thr mb sis and TLR after 1 year, in other words, very-late stent failure (VLSF). Neoather scler sis or atherosclerosis progression is thought to be the major mechanism and is regarded as a ‘final common pathway of VLSF.’ Atherosclerosis can be detected by vari us intracoronary imaging modalities; e.g., angioscopy detects it as yell w plaque that has been regarded as vulnerable plaque and is associated with futu e event f acute coronary syndrome. Here, the findings of neoatherosclerosis using int acoronary imaging are reviewed and their relation with the long - term clinical outcome is discussed.