title: Polymer-based paclitaxel-eluting stents reduce in-stent neointimal tissue proliferation: a serial volumetric intravascular ultrasound analysis from the TAXUS-IV trial.
abstract: OBJECTIVE
  The aim of this study was to use serial volumetric intravascular ultrasound (IVUS) to evaluate the effects of polymer-based, paclitaxel-eluting stents on in-stent neointima formation and late incomplete stent apposition.
  
  
  BACKGROUND
  The TAXUS-IV trial demonstrated that the slow-release, polymer-based, paclitaxel-eluting stent reduces angiographic restenosis and the need for repeat revascularization procedures. Serial IVUS studies reveal details of the pattern of vascular responses provoked by stent implantation that provide insight into device safety and efficacy.
  
  
  METHODS
  In the TAXUS-IV trial, patients were randomized to the slow-release, polymer-based, paclitaxel-eluting TAXUS stent or a bare-metal EXPRESS stent (Boston Scientific Corp., Natick, Massachusetts). As part of a formal substudy, complete volumetric IVUS data were available in 170 patients, including 88 TAXUS patients and 82 controls, at implantation and at nine-month follow-up.
  
  
  RESULTS
  No baseline differences were present in the clinical characteristics or IVUS parameters between the control and TAXUS groups. At nine-month follow-up, IVUS lumen volumes were larger in the TAXUS group (123 +/- 43 mm(3) vs. 104 +/- 44 mm(3), p = 0.005), due to a reduction in neointimal volume (18 +/- 18 mm(3) vs. 41 +/- 23 mm(3), p < 0.001). Millimeter-by-millimeter analysis within the stent demonstrated uniform suppression of neointimal growth along the entire stent length. Late lumen loss was similar at the proximal edge of the stent between the two groups, and reduced with the TAXUS stent at the distal edge (p = 0.004). Incomplete stent apposition at nine months was observed in only 3.0% of control and 4.0% of TAXUS stents (p = 0.12).
  
  
  CONCLUSIONS
  Polymer-based, paclitaxel-eluting TAXUS stents are effective in inhibiting neointimal tissue proliferation, and do not result in late incomplete stent apposition.
authors.affiliation: Washington Hospital Center, Washington, DC 20010, USA. Neil.J.Weissman@medstar.net
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Weissman
authors.forename: Joerg
authors.initials: J
authors.lastname: Koglin
authors.forename: David A
authors.initials: DA
authors.lastname: Cox
authors.forename: James
authors.initials: J
authors.lastname: Hermiller
authors.forename: Charles
authors.initials: C
authors.lastname: O'Shaughnessy
authors.forename: James Tift
authors.initials: JT
authors.lastname: Mann
authors.forename: Mark
authors.initials: M
authors.lastname: Turco
authors.forename: Ronald
authors.initials: R
authors.lastname: Caputo
authors.forename: Patrick
authors.initials: P
authors.lastname: Bergin
authors.forename: Joel
authors.initials: J
authors.lastname: Greenberg
authors.forename: Michael
authors.initials: M
authors.lastname: Kutcher
authors.forename: S Chiu
authors.initials: SC
authors.lastname: Wong
authors.forename: Warren
authors.initials: W
authors.lastname: Strickland
authors.forename: Michael
authors.initials: M
authors.lastname: Mooney
authors.forename: Mary E
authors.initials: ME
authors.lastname: Russell
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Ellis
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003327:Coronary Disease / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011108:Polymers; D015607:Stents; D017539:Tunica Intima / Q000000981:diagnostic imaging; D018084:Ultrasonography, Interventional
chemical_list: D000970:Antineoplastic Agents; D011108:Polymers; D017239:Paclitaxel