Intravascular fibrin molecular imaging improves the detection of unhealed stents assessed by optical coherence tomography in vivo

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dc.authorid0000-0001-6876-3555
dc.contributor.authorHara, Tetsuya
dc.contributor.authorUghi, Giovanni J.
dc.contributor.authorMcCarthy, Jason R.
dc.contributor.authorErdem, Sultan Sibel
dc.contributor.authorMauskapf, Adam
dc.contributor.authorLyon, Samantha C.
dc.contributor.authorFard, Ali M.
dc.contributor.authorEdelman, Elazer R.
dc.contributor.authorTearney, Guillermo J.
dc.contributor.authorJaffer, Farouc A.
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T19:52:23Z
dc.date.available10.07.201910:49:13
dc.date.available2019-07-10T19:52:23Z
dc.date.issued2017
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Temel Tıp Bilimleri Bölümü, Tıbbi Biyokimya Ana Bilim Dalı
dc.departmentİstanbul Medipol Üniversitesi, Rektörlük, Rejeneratif ve Restoratif Tıp Araştırmaları Merkezi (REMER)
dc.descriptionWOS: 000396508600010
dc.descriptionPubMed ID: 26685129
dc.description.abstractAims Fibrin deposition and absent endothelium characterize unhealed stents that are at heightened risk of stent thrombosis. Optical coherence tomography (OCT) is increasingly used for assessing stent tissue coverage as a measure of healed stents, but cannot precisely identify whether overlying tissue represents physiological neointima. Here we assessed and compared fibrin deposition and persistence on bare metal stent (BMS) and drug-eluting stent (DES) using near-infrared fluorescence (NIRF) molecular imaging in vivo, in combination with simultaneous OCT stent coverage. Methods and results Rabbits underwent implantation of one BMS and one DES without overlap in the infrarenal aorta (N = 20 3.5 x 12 mm). At Days 7 and/or 28, intravascular NIRF-OCT was performed following the injection of fibrin-targeted NIRF molecular imaging agent FTP11-CyAm7. Intravascular NIRF-OCT enabled high-resolution imaging of fibrin overlying stent struts in vivo, as validated by histopathology. Compared with BMS, DES showed greater fibrin deposition and fibrin persistence at Days 7 and 28 (P < 0.01 vs. BMS). Notably, for edge stent struts identified as covered by OCT on Day 7, 92.8 +/- 9.5% of DES and 55.8 +/- 23.6% of BMS struts were NIRF fibrin positive (P < 0.001). At Day 28, 18.6 +/- 10.6% (DES) and 5.1 +/- 8.7% (BMS) of OCT-covered struts remained fibrin positive (P < 0.001). Conclusion Intravascular NIRF fibrin molecular imaging improves the detection of unhealed stents, using clinically translatable technology that complements OCT. A sizeable percentage of struts deemed covered by OCT are actually covered by fibrin, particularly in DES, and therefore such stents might remain prothrombotic. These findings have implications for the specificity of standalone clinical OCT assessments of stent healing.
dc.description.sponsorshipNIH [R01HL108229, R01HL122388, R01GM49039, R01HL093717]; American Heart Association [13POST14640021, 13GRNT17060040]; MGH ECOR Support Fund; Kanae Foundation for Research Abroaden_US
dc.description.sponsorshipNIH R01HL108229 and R01HL122388 (F.A.J), American Heart Association (#13POST14640021 to T.H.; #13GRNT17060040 to F.A.J.), MGH ECOR Support Fund (F.A.J.), and the Kanae Foundation for Research Abroad (T.H.). E.R.E. was supported in part by NIH R01GM49039. NIH R01HL093717 (G.J.T., for development of the imaging devices); CIMIT (F.A.J. and G.J.T., for development of the imaging devices).en_US
dc.identifier.citationHara, T., Ughi, G. J., McCarthy, J. R., Erdem, S. S., Mauskapf, A., Lyon, S. C. … Jaffer, F. A. (2017). Intravascular fibrin molecular imaging improves the detection of unhealed stents assessed by optical coherence tomography in vivo. European Heart Journal, 38(6), 447-455. https://dx.doi.org/10.1093/eurheartj/ehv677
dc.identifier.doi10.1093/eurheartj/ehv677
dc.identifier.endpage455
dc.identifier.issn0195-668X
dc.identifier.issn1522-9645
dc.identifier.issue6
dc.identifier.scopusqualityQ1
dc.identifier.startpage447
dc.identifier.urihttps://dx.doi.org/10.1093/eurheartj/ehv677
dc.identifier.urihttps://hdl.handle.net/20.500.12511/2391
dc.identifier.volume38
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherOxford University Press
dc.relation.ispartofEuropean Heart Journalen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectStent Thrombosis
dc.subjectFibrin
dc.subjectMolecular Imaging
dc.subjectOptical Coherence Tomography
dc.titleIntravascular fibrin molecular imaging improves the detection of unhealed stents assessed by optical coherence tomography in vivo
dc.typeArticle

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