Evaluation of coronary remodeling after sirolimus-eluting stent implantation by serial three-dimensional intravascular ultrasound.
This study evaluates the response of the coronary vessel wall to implantation of the sirolimus-eluting stent (SES), Bx-VELOCITY, by using serial intravascular ultrasound. SESs have a major impact on the inhibition of in-stent neointimal hyperplasia. However, changes in the vessel wall and behind stent struts in animal models and humans have not been evaluated after SES implantation. Thirty-four patients who received a SES (n = 24) or a Bx-VELOCITY bare stent (BS) (n = 10) for single de novo coronary lesions and had serial motorized pullback 3-dimensional intravascular ultrasound were included. Stent, lumen, and vessel volumes were similar in the 2 groups at baseline. At follow-up, significantly larger lumen and lower neointimal hyperplasia volumes (0.7 vs 33 mm(3), p = 0.001) were seen in the SES group compared with the BS group. There was no significant difference between SES and BS in either the vessel volume (+2.4% vs +0.7%, p = NS) or the plaque behind stent volume change (+3.4% vs +2.5%, p = NS) from after the procedure to late follow-up. The stent edges also showed no significant difference between postprocedural and follow-up measurements, either in patients receiving SESs or BSs. No stented or edge segment required redilatation in the SES group, whereas 2 patients underwent repeat percutaneous coronary angioplasty in the BS group. In the SES group, 1 patient (4%) showed late acquired incomplete stent apposition. Thus, the SES is effective in inhibiting neointimal hyperplasia without affecting vessel volume and plaque behind the stent.
Degertekin
Muzaffer
M
Thoraxcenter, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
Regar
Evelyn
E
Tanabe
Kengo
K
Lemos
Pedro
P
Lee
Chi Hang
CH
Smits
Peter
P
de Feyter
Pim
P
Bruining
Niko
N
Sousa
Eduardo
E
Abizaid
Alexandre
A
Ligthart
Jurgen
J
Serruys
Patrick W
PW
D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000517:prevention & control; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000494:pharmacology* / Q000627:therapeutic use; D015607:Stents; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D018084:Ultrasonography, Interventional / Q000379:methods
D020123:Sirolimus