Neoatherosclerosis And Paleoatherosclerosis: Complications After Stenting
Anastasia V. Poznyak 1*, Victoria A. Khotina 2, Roghayyeh Vakili-Ghartavol 2,3, Victor Y Glanz 2, Vasily N. Sukhorukov 2, and Alexander N. Orekhov 2*
Journal of Angiotherapy 8(2) 1-9 https://doi.org/10.25163/angiotherapy.829450
Submitted: 01 January 2024 Revised: 25 February 2024 Published: 27 February 2024
Abstract
Neoatherosclerosis is a process of new in-stent atherosclerosis progression, it is now considered a common complication of percutaneous coronary intervention with drug-eluting stent. The development of neoatherosclerosis is a serious matter and can lead to the occurrence of late and very late stent thrombosis. Neoatherosclerosis poses a significant threat and increases the likelihood of experiencing acute coronary syndrome and angina. Paleoatherosclerosis is an advancement of pre-existing atherosclerosis, and it is also able to cause complications after stent implantation. In this review we concentrate on the atherosclerosis impact on stent restenosis and stent thrombosis, focusing on the differences between neoatherosclerosis and paleoatherosclerosis. They can lead to various complications including stent failure, although there is still much uncertainty surrounding these conditions. Numerous risk factors have been recognized that raise the likelihood of neoatherosclerosis progression, including the type of stent, kidney dysfunction, tobacco use, and low-density-lipoprotein (LDL) concentrations. These and other risk factors for neoatherosclerosis and paleoatherosclerosis development ought to be investigated in future studies in order to find causal connections and possible ways of alleviating these conditions.
Keywords: Neoatherosclerosis, Paleoatherosclerosis, Stent thrombosis, Percutaneous coronary intervention, Risk factors
References
Abouelnour, A., & Gori, T. (2022). Intravascular imaging in coronary stent restenosis: Prevention, characterization, and management. Frontiers in cardiovascular medicine, 9, 843734. https://doi.org/10.3389/fcvm.2022.843734
Agostoni, P., Vermeersch, P., Knaapen, M., & Verheye, S. (2010). Stent thrombosis is not always stent thrombosis: de novo atherosclerosis in a stented coronary segment. International journal of cardiology, 144(1), e19–e21. https://doi.org/10.1016/j.ijcard.2008.12.078
Alfonso, F., Pérez-Vizcayno, M. J., García Del Blanco, B., Otaegui, I., Masotti, M., Zueco, J., Veláquez, M., Sanchís, J., García-Touchard, A., Lázaro-García, R., Moreu, J., Bethencourt, A., Cuesta, J., Rivero, F., Cárdenas, A., Gonzalo, N., Jiménez-Quevedo, P., Fernández, C., & RIBS V Study Investigators (2016). Long-Term Results of Everolimus-Eluting Stents Versus Drug-Eluting Balloons in Patients With Bare-Metal In-Stent Restenosis: 3-Year Follow-Up of the RIBS V Clinical Trial. JACC. Cardiovascular interventions, 9(12), 1246–1255. https://doi.org/10.1016/j.jcin.2016.03.037
Almas, T., Haider, R., Malik, J., Mehmood, A., Alvi, A., Naz, H., Satti, D. I., Zaidi, S. M. J., AlSubai, A. K., AlNajdi, S., Alsufyani, R., Ramtohul, R. K., Almesri, A., Alsufyani, M., H Al-Bunnia, A., Alghamdi, H. A. S., Sattar, Y., Alraies, M. C., & Raina, S. (2022). Nanotechnology in interventional cardiology: A state-of-the-art review. International journal of cardiology. Heart & vasculature, 43, 101149. https://doi.org/10.1016/j.ijcha.2022.101149
Anastasia V. Poznyak, Ludmila V Nedosugova, Vasily N. Sukhorukov. (2023a). Hepatitis C and atherosclerosis: inflammatory interplay, Journal of Angiotherpay, 7(1), 1-10, 9361
Anastasia V. Poznyak, Varvara A. Orekhova, Vasily N. Sukhorukov. (2024c). Platelet Implication in Atherosclerosis Pathogenesis, Journal of Angiotherapy, 8(1), 1-8, 9385
Anastasia V. Poznyak, Victoria A. Khotina, Mikhail. Popov, Alexander D. Zhuravlev, Vasily N. Sukhorukov, and Alexander N. Orekhov, (2023b), The way of cholesterol in atherogenesis: from the main enemy to complex biomarkers, Journal of Angiotherpay, 7(1), 1-7
Anastasia V. Poznyak, Victoria A. Khotina, Vasily N. Sukhorukov et al., (2024b). Maternal hypercholesterolemia is a significant risk factor for atherogenesis – A Systematic Review, Journal of Angiotherapy, 8(1), 1-10, 9390
Anastasia V. Poznyak, Victoria A. Khotina, Vasily N. Sukhorukov et al., (2024a). Two Forms of C-Reactive Protein and Their Implication for Atherogenesis: Focus on Monomeric Form, Journal of Angiotherapy, 8(1), 1-12, 9386
Andreou, I., Takahashi, S., Tsuda, M., Shishido, K., Antoniadis, A. P., Papafaklis, M. I., Mizuno, S., Coskun, A. U., Saito, S., Feldman, C. L., Edelman, E. R., & Stone, P. H. (2016). Atherosclerotic plaque behind the stent changes after bare-metal and drug-eluting stent implantation in humans: Implications for late stent failure?. Atherosclerosis, 252, 9–14. https://doi.org/10.1016/j.atherosclerosis.2016.07.914
Borovac, J. A., D'Amario, D., Vergallo, R., Porto, I., Bisignani, A., Galli, M., Annibali, G., Montone, R. A., Leone, A. M., Niccoli, G., & Crea, F. (2019). Neoatherosclerosis after drug-eluting stent implantation: a novel clinical and therapeutic challenge. European heart journal. Cardiovascular pharmacotherapy, 5(2), 105–116. https://doi.org/10.1093/ehjcvp/pvy036
Bourantas, C. V., Zhang, Y., Farooq, V., Garcia-Garcia, H. M., Onuma, Y., & Serruys, P. W. (2012). Bioresorbable scaffolds: current evidence and ongoing clinical trials. Current cardiology reports, 14(5), 626–634. https://doi.org/10.1007/s11886-012-0295-5
Checkouri, E., Blanchard, V., & Meilhac, O. (2021). Macrophages in Atherosclerosis, First or Second Row Players?. Biomedicines, 9(9), 1214. https://doi.org/10.3390/biomedicines9091214
Clare, J., Ganly, J., Bursill, C. A., Sumer, H., Kingshott, P., & de Haan, J. B. (2022). The Mechanisms of Restenosis and Relevance to Next Generation Stent Design. Biomolecules, 12(3), 430. https://doi.org/10.3390/biom12030430
Condello, F., Spaccarotella, C., Sorrentino, S., Indolfi, C., Stefanini, G. G., & Polimeni, A. (2023). Stent Thrombosis and Restenosis with Contemporary Drug-Eluting Stents: Predictors and Current Evidence. Journal of clinical medicine, 12(3), 1238. https://doi.org/10.3390/jcm12031238
Condello, F., Spaccarotella, C., Sorrentino, S., Indolfi, C., Stefanini, G. G., & Polimeni, A. (2023). Stent Thrombosis and Restenosis with Contemporary Drug-Eluting Stents: Predictors and Current Evidence. Journal of clinical medicine, 12(3), 1238. https://doi.org/10.3390/jcm12031238
Cui, Y., Liu, Y., Zhao, F., Shi, D., & Chen, K. (2016). Neoatherosclerosis after Drug-Eluting Stent Implantation: Roles and Mechanisms. Oxidative medicine and cellular longevity, 2016, 5924234. https://doi.org/10.1155/2016/5924234
Davies P. F. (2009). Hemodynamic shear stress and the endothelium in cardiovascular pathophysiology. Nature clinical practice. Cardiovascular medicine, 6(1), 16–26. https://doi.org/10.1038/ncpcardio1397
Doggrell S. A. (2013). Percutaneous coronary intervention with drug-eluting stents or coronary artery bypass surgery in subjects with type 2 diabetes. Expert opinion on pharmacotherapy, 14(9), 1269–1273. https://doi.org/10.1517/14656566.2013.796932
Döring, Y., Libby, P., & Soehnlein, O. (2020). Neutrophil Extracellular Traps Participate in Cardiovascular Diseases: Recent Experimental and Clinical Insights. Circulation research, 126(9), 1228–1241. https://doi.org/10.1161/CIRCRESAHA.120.315931
Feldman, D. N., Swaminathan, R. V., Geleris, J. D., Okin, P., Minutello, R. M., Krishnan, U., McCormick, D. J., Bergman, G., Singh, H., Wong, S. C., & Kim, L. K. (2017). Comparison of Trends and In-Hospital Outcomes of Concurrent Carotid Artery Revascularization and Coronary Artery Bypass Graft Surgery: The United States Experience 2004 to 2012. JACC. Cardiovascular interventions, 10(3), 286–298. https://doi.org/10.1016/j.jcin.2016.11.032
Frodermann, V., & Nahrendorf, M. (2018). Macrophages and Cardiovascular Health. Physiological reviews, 98(4), 2523–2569. https://doi.org/10.1152/physrev.00068.2017
Gibbs, J. L., Uzun, O., Blackburn, M. E., Wren, C., Hamilton, J. R., & Watterson, K. G. (1999). Fate of the stented arterial duct. Circulation, 99(20), 2621–2625. https://doi.org/10.1161/01.cir.99.20.2621
Gori T. (2021). Vascular Wall Reactions to Coronary Stents-Clinical Implications for Stent Failure. Life (Basel, Switzerland), 11(1), 63. https://doi.org/10.3390/life11010063
Gurgoglione, F. L., Denegri, A., Russo, M., Calvieri, C., Benatti, G., & Niccoli, G. (2023). Intracoronary Imaging of Coronary Atherosclerotic Plaque: From Assessment of Pathophysiological Mechanisms to Therapeutic Implication. International journal of molecular sciences, 24(6), 5155. https://doi.org/10.3390/ijms24065155
Habib, A., & Finn, A. V. (2015). Endothelialization of drug eluting stents and its impact on dual anti-platelet therapy duration. Pharmacological research, 93, 22–27. https://doi.org/10.1016/j.phrs.2014.12.003
Itabe, H., Yamaguchi, T., Nimura, S., & Sasabe, N. (2017). Perilipins: a diversity of intracellular lipid droplet proteins. Lipids in health and disease, 16(1), 83. https://doi.org/10.1186/s12944-017-0473-y
Kozlik, M., Harpula, J., Chuchra, P. J., Nowak, M., Wojakowski, W., & Gasior, P. (2023). Drug-Eluting Stents: Technical and Clinical Progress. Biomimetics (Basel, Switzerland), 8(1), 72. https://doi.org/10.3390/biomimetics8010072
Kumar, T., Shah, M. M., Prajapati, A., & Pathak, S. (2022). A case of "very" very late stent thrombosis: More than 12 years after DES. Journal of family medicine and primary care, 11(4), 1545–1548. https://doi.org/10.4103/jfmpc.jfmpc_1533_21
Lee, C. H., & Hur, S. H. (2019). Optimization of Percutaneous Coronary Intervention Using Optical Coherence Tomography. Korean circulation journal, 49(9), 771–793. https://doi.org/10.4070/kcj.2019.0198
Lee, J. H., Jung, H. W., Kim, J. S., Hong, S. J., Ahn, C. M., Kim, B. K., Ko, Y. G., Choi, D., Hong, M. K., & Jang, Y. (2018). Different Neointimal Pattern in Early vs. Late In-Stent Restenosis and Clinical Outcomes After Drug-Coated Balloon Angioplasty - An Optical Coherence Tomography Study. Circulation journal : official journal of the Japanese Circulation Society, 82(11), 2745–2752. https://doi.org/10.1253/circj.CJ-18-0619
Lee, S. Y., Hong, M. K., & Jang, Y. (2017). Formation and Transformation of Neointima after Drug-eluting Stent Implantation: Insights from Optical Coherence Tomographic Studies. Korean circulation journal, 47(6), 823–832. https://doi.org/10.4070/kcj.2017.0157
Lee, S. Y., Hur, S. H., Lee, S. G., Kim, S. W., Shin, D. H., Kim, J. S., Kim, B. K., Ko, Y. G., Choi, D., Jang, Y., & Hong, M. K. (2015). Optical coherence tomographic observation of in-stent neoatherosclerosis in lesions with more than 50% neointimal area stenosis after second-generation drug-eluting stent implantation. Circulation. Cardiovascular interventions, 8(2), e001878. https://doi.org/10.1161/CIRCINTERVENTIONS.114.001878
Luo, X., Lv, Y., Bai, X., Qi, J., Weng, X., Liu, S., Bao, X., Jia, H., & Yu, B. (2021). Plaque Erosion: A Distinctive Pathological Mechanism of Acute Coronary Syndrome. Frontiers in cardiovascular medicine, 8, 711453. https://doi.org/10.3389/fcvm.2021.711453
Lupu, F., Kinasewitz, G., & Dormer, K. (2020). The role of endothelial shear stress on haemodynamics, inflammation, coagulation and glycocalyx during sepsis. Journal of cellular and molecular medicine, 24(21), 12258–12271. https://doi.org/10.1111/jcmm.15895
Mankerious, N., Micha, J., & Kufner, S. (2018). Malapposed, uncovered, underexpanded-intravascular imaging lessons on coronary stent thrombosis. Journal of thoracic disease, 10(1), 141–144. https://doi.org/10.21037/jtd.2017.12.44
Mitra, A. K., & Agrawal, D. K. (2006). In stent restenosis: bane of the stent era. Journal of clinical pathology, 59(3), 232–239. https://doi.org/10.1136/jcp.2005.025742
Montarello, N. J., Nelson, A. J., Verjans, J., Nicholls, S. J., & Psaltis, P. J. (2020). The role of intracoronary imaging in translational research. Cardiovascular diagnosis and therapy, 10(5), 1480–1507. https://doi.org/10.21037/cdt-20-1
Niccoli, G., D'Amario, D., Borovac, J. A., Santangelo, E., Scalone, G., Fracassi, F., Vergallo, R., Vetrugno, V., Copponi, G., Severino, A., Liuzzo, G., Imaeva, A., Siracusano, A., & Crea, F. (2018). Perilipin 2 levels are increased in patients with in-stent neoatherosclerosis: A clue to mechanisms of accelerated plaque formation after drug-eluting stent implantation. International journal of cardiology, 258, 55–58. https://doi.org/10.1016/j.ijcard.2018.01.074
Nishino, S., Sakuma, M., Kanaya, T., Nasuno, T., Tokura, M., Toyoda, S., Abe, S., Nakamura, D., Tanaka, K., Attizzani, G. F., Bezerra, H. G., Costa, M. A., & Inoue, T. (2019). Neointimal tissue characterization after implantation of drug-eluting stents by optical coherence tomography: quantitative analysis of optical density. The international journal of cardiovascular imaging, 35(11), 1971–1978. https://doi.org/10.1007/s10554-019-01651-4
Nusca, A., Viscusi, M. M., Piccirillo, F., De Filippis, A., Nenna, A., Spadaccio, C., Nappi, F., Chello, C., Mangiacapra, F., Grigioni, F., Chello, M., & Ussia, G. P. (2022). In Stent Neo-Atherosclerosis: Pathophysiology, Clinical Implications, Prevention, and Therapeutic Approaches. Life (Basel, Switzerland), 12(3), 393. https://doi.org/10.3390/life12030393
Papafaklis, M. I., Koskinas, K. C., Chatzizisis, Y. S., Stone, P. H., & Feldman, C. L. (2010). In-vivo assessment of the natural history of coronary atherosclerosis: vascular remodeling and endothelial shear stress determine the complexity of atherosclerotic disease progression. Current opinion in cardiology, 25(6), 627–638. https://doi.org/10.1097/HCO.0b013e32833f0236
Park, S. J., Kang, S. J., Virmani, R., Nakano, M., & Ueda, Y. (2012). In-stent neoatherosclerosis: a final common pathway of late stent failure. Journal of the American College of Cardiology, 59(23), 2051–2057. https://doi.org/10.1016/j.jacc.2011.10.909
Plakkal Ayyappan, J., Paul, A., & Goo, Y. H. (2016). Lipid droplet-associated proteins in atherosclerosis (Review). Molecular medicine reports, 13(6), 4527–4534. https://doi.org/10.3892/mmr.2016.5099
Puranik, A. S., Dawson, E. R., & Peppas, N. A. (2013). Recent advances in drug eluting stents. International journal of pharmaceutics, 441(1-2), 665–679. https://doi.org/10.1016/j.ijpharm.2012.10.029
Redfors, B., Généreux, P., Witzenbichler, B., Maehara, A., Weisz, G., McAndrew, T., Mehran, R., Kirtane, A. J., & Stone, G. W. (2018). Percutaneous coronary intervention of lesions with in-stent restenosis: A report from the ADAPT-DES study. American heart journal, 197, 142–149. https://doi.org/10.1016/j.ahj.2017.11.011
Tada, T., Byrne, R. A., Simunovic, I., King, L. A., Cassese, S., Joner, M., Fusaro, M., Schneider, S., Schulz, S., Ibrahim, T., Ott, I., Massberg, S., Laugwitz, K. L., & Kastrati, A. (2013). Risk of stent thrombosis among bare-metal stents, first-generation drug-eluting stents, and second-generation drug-eluting stents: results from a registry of 18,334 patients. JACC. Cardiovascular interventions, 6(12), 1267–1274. https://doi.org/10.1016/j.jcin.2013.06.015
Taniwaki, M., Windecker, S., Zaugg, S., Stefanini, G. G., Baumgartner, S., Zanchin, T., Wenaweser, P., Meier, B., Jüni, P., & Räber, L. (2015). The association between in-stent neoatherosclerosis and native coronary artery disease progression: a long-term angiographic and optical coherence tomography cohort study. European heart journal, 36(32), 2167–2176. https://doi.org/10.1093/eurheartj/ehv227
Theofilis, P., Sagris, M., Oikonomou, E., Antonopoulos, A. S., Siasos, G., Tsioufis, C., & Tousoulis, D. (2021). Inflammatory Mechanisms Contributing to Endothelial Dysfunction. Biomedicines, 9(7), 781. https://doi.org/10.3390/biomedicines9070781
Upadhyay R. K. (2015). Emerging risk biomarkers in cardiovascular diseases and disorders. Journal of lipids, 2015, 971453. https://doi.org/10.1155/2015/971453
Vasavada, A. M., Singh, P., Firdaus, A., Meenashi Sundaram, D., Patel, M., Singh, G., Palanisamy, L., Ansari, S. A., Thummala, S., & Pandya, H. (2023). Carotid Endarterectomy Versus Stenting for the Treatment of Patients With Carotid Artery Stenosis: An Updated Systematic Review and Meta-Analysis. Cureus, 15(2), e35070. https://doi.org/10.7759/cureus.35070
Wang, J., Jin, X., Huang, Y., Ran, X., Luo, D., Yang, D., Jia, D., Zhang, K., Tong, J., Deng, X., & Wang, G. (2018). Endovascular stent-induced alterations in host artery mechanical environments and their roles in stent restenosis and late thrombosis. Regenerative biomaterials, 5(3), 177–187. https://doi.org/10.1093/rb/rby006
Zhang, B. C., Karanasos, A., & Regar, E. (2015). OCT demonstrating neoatherosclerosis as part of the continuous process of coronary artery disease. Herz, 40(6), 845–854. https://doi.org/10.1007/s00059-015-4343-y
Zhang, J., Zhang, Q., Zhao, K., Bian, Y. J., Liu, Y., & Xue, Y. T. (2022). Risk factors for in-stent restenosis after coronary stent implantation in patients with coronary artery disease: A retrospective observational study. Medicine, 101(47), e31707. https://doi.org/10.1097/MD.0000000000031707
Zhang, M., Cresswell, N., Tavora, F., Mont, E., Zhao, Z., & Burke, A. (2014). In-stent restenosis is associated with neointimal angiogenesis and macrophage infiltrates. Pathology, research and practice, 210(12), 1026–1030. https://doi.org/10.1016/j.prp.2014.04.004
View Dimensions
View Altmetric
Save
Citation
View
Share