Neointimal coverage of sirolimus-eluting stents at 6-month follow-up: evaluated by optical coherence tomography.
OBJECTIVE
Since the intravascular ultrasound (IVUS) cannot detect neointimal layers in the majority of sirolimus-eluting stents (SES) at the chronic phase, it is still controversial to what extent SES remain uncovered. However, optical coherence tomography (OCT) with excellent resolution may be able to detect thinner neointima.


RESULTS
A total of 34 patients (57 SES) underwent OCT and IVUS evaluations at 6-month follow-up. The thickness of neointima on each SES strut cross-section and strut apposition to the vessel wall was evaluated. By OCT evaluation, the median (25th, 75th percentiles) neointima thickness was 52.5 microm (28.0 microm, 147.6 microm) and the prevalence of struts covered by thin neointima undetectable by IVUS was 64%. The average rate of neointima-covered struts in an individual SES was 89%. Nine SES (16%) showed full coverage by neointima, whereas the remaining stents had partially uncovered strut lesions. Among the 6840 struts visualized by OCT in all of the SES, 79 struts showed malapposition without neointimal coverage, and were frequently observed in the areas of SES overlap.


CONCLUSIONS
At 6 months, most of the SES were covered with thin neointima, but few showed full coverage.
Matsumoto
Daisuke
D
Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo 650-0017, Japan.
Shite
Junya
J
Shinke
Toshiro
T
Otake
Hiromasa
H
Tanino
Yusuke
Y
Ogasawara
Daisuke
D
Sawada
Takahiro
T
Paredes
Oscar Luis
OL
Hirata
Ken-ichi
K
Yokoyama
Mitsuhiro
M
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D002404:Catheterization; D049109:Cell Proliferation; D023903:Coronary Restenosis / Q000188:drug therapy* / Q000473:pathology; D003328:Coronary Thrombosis / Q000473:pathology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D013988:Ticlopidine / Q000627:therapeutic use; D041623:Tomography, Optical Coherence; D017539:Tunica Intima / Q000473:pathology*
D007166:Immunosuppressive Agents; D013988:Ticlopidine; D001241:Aspirin; D020123:Sirolimus