Neoatherosclerosis(NA)within stents has become an important clinical problem after coronary artery stent implantation.In-stent restenosis and in-stent thrombosis are the two major complications following coronary sten...Neoatherosclerosis(NA)within stents has become an important clinical problem after coronary artery stent implantation.In-stent restenosis and in-stent thrombosis are the two major complications following coronary stent placement and seriously affect patient prognosis.As the common pathological basis of these two complications,NA plaques,unlike native atherosclerotic plaques,often grow around residual oxidized lipids and stent struts.The main components are foam cells formed by vascular smooth muscle cells(VSMCs)engulfing oxidized lipids at lipid residue sites.Current research mainly focuses on optical coherence tomography(OCT)and intravascular ultrasound(IVUS),but the specific pathogenesis of NA is still unclear.A thorough understanding of the pathogenesis and pathological features of NA provides a theoretical basis for clinical treatment.This article reviews the previous research of our research group and the current situation of domestic and foreign research.展开更多
Chronic inflammation of the native vessel wall with infiltration of lipid-laden foamy macrophages through impaired endothelium results in atherosclerosis. Percutaneous coronary intervention, including metallic stent i...Chronic inflammation of the native vessel wall with infiltration of lipid-laden foamy macrophages through impaired endothelium results in atherosclerosis. Percutaneous coronary intervention, including metallic stent implantation, is now widely utilized for the treatment of atherosclerotic lesions of the coronary artery. Baremetal stents and the subsequently developed drugeluting stents seal the atherosclerosis and resolve lumen stenosis or obstruction of the epicardial coronary artery and myocardial ischemia. After stent implantation, neointima proliferates within the stented segment. Chronic inflammation caused by a foreign body reaction to the implanted stent and subsequent neovascularization, which is characterized by the continuous recruitment of macrophages into the vessel, result in the transformation of the usual neointima into an atheromatous neointima. Neointima with an atherosclerotic appearance, such as that caused by thin-cap fibroatheromas, is now recognized as neoatherosclerosis, which can sometimes cause in-stent restenosis and acute thrombotic occlusion originating from the stent segment following disruption of the atheroma. Neoatherosclerosis is emerging as a new coronary stent-associated problem that has not yet been resolved. In this review article, we will discuss possible mechanisms, clinical challenges, and the future outlook of neoatherosclerosis.展开更多
基金supported by grants from the National Natural Science Foundation of China(Nos.82070376 and 81873491).
文摘Neoatherosclerosis(NA)within stents has become an important clinical problem after coronary artery stent implantation.In-stent restenosis and in-stent thrombosis are the two major complications following coronary stent placement and seriously affect patient prognosis.As the common pathological basis of these two complications,NA plaques,unlike native atherosclerotic plaques,often grow around residual oxidized lipids and stent struts.The main components are foam cells formed by vascular smooth muscle cells(VSMCs)engulfing oxidized lipids at lipid residue sites.Current research mainly focuses on optical coherence tomography(OCT)and intravascular ultrasound(IVUS),but the specific pathogenesis of NA is still unclear.A thorough understanding of the pathogenesis and pathological features of NA provides a theoretical basis for clinical treatment.This article reviews the previous research of our research group and the current situation of domestic and foreign research.
文摘Chronic inflammation of the native vessel wall with infiltration of lipid-laden foamy macrophages through impaired endothelium results in atherosclerosis. Percutaneous coronary intervention, including metallic stent implantation, is now widely utilized for the treatment of atherosclerotic lesions of the coronary artery. Baremetal stents and the subsequently developed drugeluting stents seal the atherosclerosis and resolve lumen stenosis or obstruction of the epicardial coronary artery and myocardial ischemia. After stent implantation, neointima proliferates within the stented segment. Chronic inflammation caused by a foreign body reaction to the implanted stent and subsequent neovascularization, which is characterized by the continuous recruitment of macrophages into the vessel, result in the transformation of the usual neointima into an atheromatous neointima. Neointima with an atherosclerotic appearance, such as that caused by thin-cap fibroatheromas, is now recognized as neoatherosclerosis, which can sometimes cause in-stent restenosis and acute thrombotic occlusion originating from the stent segment following disruption of the atheroma. Neoatherosclerosis is emerging as a new coronary stent-associated problem that has not yet been resolved. In this review article, we will discuss possible mechanisms, clinical challenges, and the future outlook of neoatherosclerosis.
