Angioscopic Evaluation of Atrial Septal Defect Closure Device Neo‐Endothelialization

Background Current guidelines recommend at least 6 months of antithrombotic therapy and antibiotic prophylaxis after septal‐occluding device deployment in transcatheter closure of atrial septal defect. It has been estimated that it takes ≈6 months for complete neo‐endothelialization; however, neo‐en...

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Autores principales:	Yasuhiro Tanabe, Tomomi Suzuki, Shingo Kuwata, Masaki Izumo, Hiromasa Kawaguchi, Shun Ogoda, Nozomi Kotoku, Yukio Sato, Haruka Nishikawa, Toshiki Kaihara, Masashi Koga, Takanobu Mitarai, Kazuaki Okuyama, Ryo Kamijima, Yuki Ishibashi, Kihei Yoneyama, Takumi Higuma, Tomoo Harada, Yoshihiro J. Akashi
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	angioscopy atrial septal defect device neo‐endothelialization Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/f70c2f2215d84c93b17bb5c1d3262b15
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spelling	oai:doaj.org-article:f70c2f2215d84c93b17bb5c1d3262b152021-11-23T11:36:35ZAngioscopic Evaluation of Atrial Septal Defect Closure Device Neo‐Endothelialization10.1161/JAHA.120.0192822047-9980https://doaj.org/article/f70c2f2215d84c93b17bb5c1d3262b152021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.120.019282https://doaj.org/toc/2047-9980Background Current guidelines recommend at least 6 months of antithrombotic therapy and antibiotic prophylaxis after septal‐occluding device deployment in transcatheter closure of atrial septal defect. It has been estimated that it takes ≈6 months for complete neo‐endothelialization; however, neo‐endothelialization has not previously been assessed in vivo in humans. Methods and Results The neointimal coverage of septal occluder devices was evaluated 6 months after implantation in 15 patients by angioscopy from the right atrium. Each occluder surface was divided into 9 areas; the levels of endothelialization in each area were semiquantitatively assessed by 4‐point grades. Device neo‐endothelialization was sufficient in two thirds of patients, but insufficient in one third. In the comparison between patients with sufficiently endothelialized devices of average grade score ≥2 (good endothelialization group, n=10) and those with poorly endothelialized devices of average grade score <2 (poor endothelialization group, n=5), those in the poor endothelialization group had larger devices deployed (27.0 mm [25.0–31.5 mm] versus 17.0 mm [15.6–22.5 mm], respectively) and progressive right heart dilatation. The endothelialization was poorer around the central areas. Moreover, the prevalence of thrombus formation on the devices was higher in the poorly endothelialized areas than in the sufficiently endothelialized areas (Grade 0, 94.1%; Grade 1, 63.2%; Grade 2, 0%; Grade 3, 1.6%). Conclusions Neo‐endothelialization on the closure devices varied 6 months after implantation. Notably, poor endothelialization and thrombus attachment were observed around the central areas and on the larger devices.Yasuhiro TanabeTomomi SuzukiShingo KuwataMasaki IzumoHiromasa KawaguchiShun OgodaNozomi KotokuYukio SatoHaruka NishikawaToshiki KaiharaMasashi KogaTakanobu MitaraiKazuaki OkuyamaRyo KamijimaYuki IshibashiKihei YoneyamaTakumi HigumaTomoo HaradaYoshihiro J. AkashiWileyarticleangioscopyatrial septal defectdevice neo‐endothelializationDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	angioscopy atrial septal defect device neo‐endothelialization Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	angioscopy atrial septal defect device neo‐endothelialization Diseases of the circulatory (Cardiovascular) system RC666-701 Yasuhiro Tanabe Tomomi Suzuki Shingo Kuwata Masaki Izumo Hiromasa Kawaguchi Shun Ogoda Nozomi Kotoku Yukio Sato Haruka Nishikawa Toshiki Kaihara Masashi Koga Takanobu Mitarai Kazuaki Okuyama Ryo Kamijima Yuki Ishibashi Kihei Yoneyama Takumi Higuma Tomoo Harada Yoshihiro J. Akashi Angioscopic Evaluation of Atrial Septal Defect Closure Device Neo‐Endothelialization
description	Background Current guidelines recommend at least 6 months of antithrombotic therapy and antibiotic prophylaxis after septal‐occluding device deployment in transcatheter closure of atrial septal defect. It has been estimated that it takes ≈6 months for complete neo‐endothelialization; however, neo‐endothelialization has not previously been assessed in vivo in humans. Methods and Results The neointimal coverage of septal occluder devices was evaluated 6 months after implantation in 15 patients by angioscopy from the right atrium. Each occluder surface was divided into 9 areas; the levels of endothelialization in each area were semiquantitatively assessed by 4‐point grades. Device neo‐endothelialization was sufficient in two thirds of patients, but insufficient in one third. In the comparison between patients with sufficiently endothelialized devices of average grade score ≥2 (good endothelialization group, n=10) and those with poorly endothelialized devices of average grade score <2 (poor endothelialization group, n=5), those in the poor endothelialization group had larger devices deployed (27.0 mm [25.0–31.5 mm] versus 17.0 mm [15.6–22.5 mm], respectively) and progressive right heart dilatation. The endothelialization was poorer around the central areas. Moreover, the prevalence of thrombus formation on the devices was higher in the poorly endothelialized areas than in the sufficiently endothelialized areas (Grade 0, 94.1%; Grade 1, 63.2%; Grade 2, 0%; Grade 3, 1.6%). Conclusions Neo‐endothelialization on the closure devices varied 6 months after implantation. Notably, poor endothelialization and thrombus attachment were observed around the central areas and on the larger devices.
format	article
author	Yasuhiro Tanabe Tomomi Suzuki Shingo Kuwata Masaki Izumo Hiromasa Kawaguchi Shun Ogoda Nozomi Kotoku Yukio Sato Haruka Nishikawa Toshiki Kaihara Masashi Koga Takanobu Mitarai Kazuaki Okuyama Ryo Kamijima Yuki Ishibashi Kihei Yoneyama Takumi Higuma Tomoo Harada Yoshihiro J. Akashi
author_facet	Yasuhiro Tanabe Tomomi Suzuki Shingo Kuwata Masaki Izumo Hiromasa Kawaguchi Shun Ogoda Nozomi Kotoku Yukio Sato Haruka Nishikawa Toshiki Kaihara Masashi Koga Takanobu Mitarai Kazuaki Okuyama Ryo Kamijima Yuki Ishibashi Kihei Yoneyama Takumi Higuma Tomoo Harada Yoshihiro J. Akashi
author_sort	Yasuhiro Tanabe
title	Angioscopic Evaluation of Atrial Septal Defect Closure Device Neo‐Endothelialization
title_short	Angioscopic Evaluation of Atrial Septal Defect Closure Device Neo‐Endothelialization
title_full	Angioscopic Evaluation of Atrial Septal Defect Closure Device Neo‐Endothelialization
title_fullStr	Angioscopic Evaluation of Atrial Septal Defect Closure Device Neo‐Endothelialization
title_full_unstemmed	Angioscopic Evaluation of Atrial Septal Defect Closure Device Neo‐Endothelialization
title_sort	angioscopic evaluation of atrial septal defect closure device neo‐endothelialization
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/f70c2f2215d84c93b17bb5c1d3262b15
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Angioscopic Evaluation of Atrial Septal Defect Closure Device Neo‐Endothelialization

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