title: Evaluation of coronary remodeling after sirolimus-eluting stent implantation by serial three-dimensional intravascular ultrasound.
abstract: 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.
authors.affiliation: Thoraxcenter, Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Degertekin
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
authors.forename: Kengo
authors.initials: K
authors.lastname: Tanabe
authors.forename: Pedro
authors.initials: P
authors.lastname: Lemos
authors.forename: Chi Hang
authors.initials: CH
authors.lastname: Lee
authors.forename: Peter
authors.initials: P
authors.lastname: Smits
authors.forename: Pim
authors.initials: P
authors.lastname: de Feyter
authors.forename: Niko
authors.initials: N
authors.lastname: Bruining
authors.forename: Eduardo
authors.initials: E
authors.lastname: Sousa
authors.forename: Alexandre
authors.initials: A
authors.lastname: Abizaid
authors.forename: Jurgen
authors.initials: J
authors.lastname: Ligthart
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: 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
chemical_list: D020123:Sirolimus