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2015 ; 7
(11
): 776-83
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gab.com Text
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English Wikipedia
Neoatherosclerosis: Coronary stents seal atherosclerotic lesions but result in
making a new problem of atherosclerosis
#MMPMID26635925
Komiyama H
; Takano M
; Hata N
; Seino Y
; Shimizu W
; Mizuno K
World J Cardiol
2015[Nov]; 7
(11
): 776-83
PMID26635925
show ga
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. Bare-metal stents and the subsequently developed drug-eluting 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.