Image in Cardiology
Different patterns of in-stent coverage in drug-eluting stents
Diferentes padrões de cobertura intra-stent em stents farmacológicos
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optical coherence tomography (OCT) demonstrating a heterogeneous hypointensive neointima with a bright superficial layer (arrow) and presence of macrophage infiltration and microvessels (asterisk) into the neointima in the first-generation DES (B and b), and a homogeneous hyperintensive neointima in the second-generation DES (C and c); OCT post-stent (D) showing good expansion and apposition of the bioresorbable scaffold.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Daniele Gemma, Santiago Jimenez Valero, Raúl Moreno Gómez, Francisco Javier Irazusta Córdoba, Pablo Merás Colunga, José Luis López-Sendón" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Daniele" "apellidos" => "Gemma" ] 1 => array:2 [ "nombre" => "Santiago Jimenez" "apellidos" => "Valero" ] 2 => array:2 [ "nombre" => "Raúl Moreno" "apellidos" => "Gómez" ] 3 => array:2 [ "nombre" => "Francisco Javier Irazusta" "apellidos" => "Córdoba" ] 4 => array:2 [ "nombre" => "Pablo Merás" "apellidos" => "Colunga" ] 5 => array:2 [ "nombre" => "José Luis" "apellidos" => "López-Sendón" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0870255117307849" "doi" => "10.1016/j.repc.2017.01.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117307849?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204917303252?idApp=UINPBA00004E" "url" => "/21742049/0000003600000011/v1_201712190639/S2174204917303252/v1_201712190639/en/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S0870255117303621" "issn" => "08702551" "doi" => "10.1016/j.repc.2017.01.004" "estado" => "S300" "fechaPublicacion" => "2017-11-01" "aid" => "1014" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2017;36:875-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1821 "formatos" => array:3 [ "EPUB" => 143 "HTML" => 1349 "PDF" => 329 ] ] "pt" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagem em Cardiologia</span>" "titulo" => "Miocardiopatia em dentes de serra: uma causa rara de insuficiência cardíaca" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "875" "paginaFinal" => "876" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Sawtooth cardiomyopathy: A rare cause of heart failure" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2021 "Ancho" => 3001 "Tamanyo" => 563486 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Painel A – ecocardiograma transtorácico bidimensional, projeção apical quatro câmaras modificada, demonstrando projeções miocárdicas ecodensas com morfologia em «dentes de serra».</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Painel B – ecocardiograma transtorácico bidimensional, projeção apical quatro câmaras modificada, demonstrando projeções miocárdicas ecodensas com morfologia em «dentes de serra».</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Painel C – ressonância magnética cardíaca, eixo longo duas câmaras, demonstrando projeções de miocárdio aparentemente compacto com origem na parede inferior do VE.</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Painel D – ressonância magnética cardíaca, corte axial quatro câmaras, demonstrando projeções de miocárdio aparentemente compacto com origem na parede lateral do VE e na face esquerda do septo interventricular.</p> <p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Painel E – ressonância magnética cardíaca, corte axial quatro câmaras, demonstrando projeções de miocárdio aparentemente compacto com origem na parede lateral do VE e na face esquerda do septo interventricular.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Bárbara de Pinho Cardoso, Conceição Trigo, Nuno Jalles Tavares, Fátima F. 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The patient underwent new coronary angiography for effort angina, which demonstrated diffuse restenosis of the proximal stent, with a 71% obstructive lesion in the mid portion (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>A).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Optical coherence tomography demonstrated two different patterns of in-stent coverage in the two stents: mild proliferation of a homogeneous hyperintense neointima highly suggestive of classic (‘healthy’) neointimal thickening in the distal stent, with minimal luminal area (MLA) of 3.8 mm<span class="elsevierStyleSup">2</span> (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>C and c); and a heterogeneous hypointense neointima with low attenuation suggesting an active inflammatory process causing severe restenosis of the TAXUS stent (MLA 2.1 mm<span class="elsevierStyleSup">2</span>) (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>B and b).</p><p id="par0015" class="elsevierStylePara elsevierViewall">Following predilatation, an Absorb everolimus-eluting bioresorbable scaffold (BRS) (Abbott Vascular, CA) was implanted into the proximal stent, with good results (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>D).</p><p id="par0020" class="elsevierStylePara elsevierViewall">This case reveals a process of restenosis in a first-generation DES and normal neointimal coverage in a second-generation DES implanted in a single patient and artery in the same procedure.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-09-21" "fechaAceptado" => "2017-01-06" "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1902 "Ancho" => 3167 "Tamanyo" => 767895 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Initial coronary angiography (A, a) showing diffuse restenosis of the proximal stent and a good late result of the distal stent (arrows); optical coherence tomography (OCT) demonstrating a heterogeneous hypointensive neointima with a bright superficial layer (arrow) and presence of macrophage infiltration and microvessels (asterisk) into the neointima in the first-generation DES (B and b), and a homogeneous hyperintensive neointima in the second-generation DES (C and c); OCT post-stent (D) showing good expansion and apposition of the bioresorbable scaffold.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/08702551/0000003600000011/v2_201801180628/S0870255117307849/v2_201801180628/en/main.assets" "Apartado" => array:4 [ "identificador" => "29264" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imagens em Cardiologia" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/08702551/0000003600000011/v2_201801180628/S0870255117307849/v2_201801180628/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255117307849?idApp=UINPBA00004E" ]
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