Angiographic and 3D intravascular ultrasound assessment of overlapping bare metal stent and three different formulations of drug-eluting stents in patients with diabetes mellitus.
OBJECTIVE
The aim of this study was to examine the impact of overlapping bare-metal stent (BMS) and three different formulations of drug-eluting stent (DES) on intimal hyperplasia (IH) response of patients with diabetes mellitus (DM).


METHODS
Forty-nine DM patients treated with overlapping BMS (19 lesions), sirolimus-eluting stent (SES 12 lesions), paclitaxel-eluting stent (PES 8 lesions) or tacrolimus-eluting stent (TES 10 lesions) were studied. Baseline and 9-month follow-up volumetric intravascular vascular ultrasound (IVUS) and quantitative coronary angiography (QCA) analysis were performed in the entire stented segment and in the overlapped (OL) and non-overlapped (non-OL) subsegments. Clinical outcomes were evaluated at 1-year follow-up.


RESULTS
Post-procedure (PO-) QCA measurements were similar in all stent groups, and between OL and non-OL subsegments in each individual type of stents. Percent IH was lower in SES and PES vs. BMS (p < 0.05). Percent IH was significantly greater in OL subsegment compared with non-OL subsegment in BMS (p < 0.05), but not in all type of DES groups. SES showed significantly less %IH compared with PES and TES in OL and non-OL subsegments. Vessel area at the OL remained unchanged from PO to FU in all type of DES and BMS groups. There were no aneurysm formation and no stent thrombosis up to 1-year follow-up.


CONCLUSIONS
Overlapping BMS is associated with enhanced IH response in diabetic patients, whereas overlapping DES, particularly SES and PES, appear effective to inhibit IH without detectable late vascular adverse effects.
Kawaguchi
Ren
R
Division of Cardiology and Cardiovascular Imaging Core Laboratories, University of Florida Shands Jacksonville, Jacksonville, FL 32209, USA.
Sabate
Manel
M
Angiolillo
Dominick J
DJ
Jimenez-Quevedo
Pilar
P
Suzuki
Nobuaki
N
Corros
Cecilia
C
Futamatsu
Hideki
H
Alfonso
Fernando
F
Hernandez-Antolin
Rosana
R
Macaya
Carlos
C
Bass
Theodore A
TA
Costa
Marco A
MA
D000704:Analysis of Variance; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D048909:Diabetes Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000517:prevention & control; D021621:Imaging, Three-Dimensional; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage; D011446:Prospective Studies; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents; D016559:Tacrolimus / Q000008:administration & dosage; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000187:drug effects*; D018084:Ultrasonography, Interventional
D017239:Paclitaxel; D020123:Sirolimus; D016559:Tacrolimus