title: Two-year serial coronary angiographic and intravascular ultrasound analysis of in-stent angiographic late lumen loss and ultrasonic neointimal volume from the TAXUS II trial.
abstract: Late loss has been used as a reliable surrogate end point for evaluation and differentiation of short-term performance of drug-eluting stents. This study investigated the consistency between angiographic and intravascular ultrasound (IVUS) outcomes of late lumen loss (late loss) and neointimal growth to measure restenotic plaque load in TAXUS and bare metal stents. The randomized TAXUS II trial evaluates the polymer-based paclitaxel-eluting TAXUS stent in slow- and moderate-release formulations. Serial angiographic and IVUS analyses were available in 155 event-free patients (bare metal stent, 74; TAXUS stent, 81) after the procedure, at 6 months, and at 2 years. For this subanalysis, quantitative coronary angiographic (QCA) and IVUS measurements were used to derive late loss and neointimal volume. From after the procedure to 6 months, quantitative coronary angiography and IVUS showed matching results for the 2 groups with significant decreases in late loss and neointimal volume in the TAXUS versus the control group. From 6 months to 2 years, QCA and IVUS measurements also showed results similar to those in the control group, demonstrating neointimal compaction over time. However, in the TAXUS group, QCA late loss showed a nonsignificant decrease from 6 months to 2 years, whereas IVUS neointimal volume increased. In conclusion, although QCA and IVUS results were similar over the first 6 months, long-term assessment of changes in restenotic plaque load showed discrepant findings for the TAXUS. These findings suggest the need for critical reevaluation of current end points and the use of more precise techniques to detect lumen and stent boundaries.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tsuchida
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Nico
authors.initials: N
authors.lastname: Bruining
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
authors.forename: Janusz
authors.initials: J
authors.lastname: Drzewiecki
authors.forename: Adrian P
authors.initials: AP
authors.lastname: Banning
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zmudka
authors.forename: Francois
authors.initials: F
authors.lastname: Schiele
authors.forename: Zheng
authors.initials: Z
authors.lastname: Zhou
authors.forename: Tessa A M
authors.initials: TA
authors.lastname: Rademaker
authors.forename: Gerrit-Anne
authors.initials: GA
authors.lastname: van Es
authors.forename: Joerg
authors.initials: J
authors.lastname: Koglin
authors.forename: Mary E
authors.initials: ME
authors.lastname: Russell
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D017023:Coronary Angiography; D003327:Coronary Disease / Q000628:therapy*; D004867:Equipment Design; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D018084:Ultrasonography, Interventional
chemical_list: D050257:Tubulin Modulators; D017239:Paclitaxel