In-vivo iMap IVUS comparison of in-stent neointima and native coronary atherosclerosis

•We analyzed in-stent neointima and atherosclerotic plaque by iMap IVUS•We found more vulnerable plaque pattern proximal to the stent compared to neointima•We observed more necrotic tissue in proximal segment to the stent compared with distal

PurposeThe purpose of this study was to compare plaque characteristics of native coronary atherosclerosis and in-stent neointima ten months after ST elevation myocardial infarction (STEMI) using iMap intravascular ultrasound (IVUS).MethodsIn 49 patients in-stent neointima and the coronary segment proximal to the stent were analyzed with iMap intravascular ultrasound (IVUS) ten months after primary PCI for STEMI.ResultsA higher percentage of necrotic tissue was observed in the proximal coronary segment compared to the in-stent neointima by iMap IVUS (25.5% ± 12.8% vs 12.3% ± 3.3%, p < 0.0001) ten months after STEMI. The proportion of fibrotic tissue in the proximal segment was lower (63.6% ± 14.8% vs 72.0% ± 5.7%, p = 0.002) and the proportion of the lipidic tissue was higher (8.8% ± 3.0% vs 5.9% ± 2.0%, p < 0.0001) than in-stent neointima.ConclusionsIn patients ten months after STEMI, in-stent neointima contained a higher proportion of fibrotic tissue and lower proportion of necrotic and lipidic tissue compared the native atherosclerotic lesion.