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Komiyama H, Takano M, Hata N, et al. Neoatherosclerosis: Coronary stents seal atherosclerotic lesions but result in making a new problem of atherosclerosis. World J Cardiol. 2015;7(11):776-83doi: 10.4330/wjc.v7.i11.776.
Komiyama, H., Takano, M., Hata, N., Seino, Y., Shimizu, W., & Mizuno, K. (2015). Neoatherosclerosis: Coronary stents seal atherosclerotic lesions but result in making a new problem of atherosclerosis. World journal of cardiology, 7(11), 776-83. https://doi.org/10.4330/wjc.v7.i11.776
Komiyama, Hidenori, et al. "Neoatherosclerosis: Coronary stents seal atherosclerotic lesions but result in making a new problem of atherosclerosis." World journal of cardiology vol. 7,11 (2015): 776-83. doi: https://doi.org/10.4330/wjc.v7.i11.776
Komiyama H, Takano M, Hata N, Seino Y, Shimizu W, Mizuno K. Neoatherosclerosis: Coronary stents seal atherosclerotic lesions but result in making a new problem of atherosclerosis. World J Cardiol. 2015 Nov 26;7(11):776-83. doi: 10.4330/wjc.v7.i11.776. PMID: 26635925; PMCID: PMC4660472.
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World J Cardiol. 2015 Nov 26;7(11):776-83. doi: 10.4330/wjc.v7.i11.776.

Neoatherosclerosis: Coronary stents seal atherosclerotic lesions but result in making a new problem of atherosclerosis.

World journal of cardiology

Hidenori Komiyama, Masamichi Takano, Noritake Hata, Yoshihiko Seino, Wataru Shimizu, Kyoichi Mizuno

Affiliations

  1. Hidenori Komiyama, Masamichi Takano, Noritake Hata, Yoshihiko Seino, Cardiovascular Center, Chiba Hokusou Hospital, Nippon Medical School, Chiba 270-1613, Japan.

PMID: 26635925 PMCID: PMC4660472 DOI: 10.4330/wjc.v7.i11.776

Abstract

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.

Keywords: Atherosclerosis; Drug-eluting stent; Neoatherosclerosis; Percutaneous coronary intervention

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