title: Heterogeneous arterial healing in patients following paclitaxel-eluting stent implantation: comparison with sirolimus-eluting stents.
abstract: OBJECTIVE
  We angioscopically compared paclitaxel-eluting stents (PES) and sirolimus-eluting stents (SES) to explore differences in arterial healing.
  
  
  BACKGROUND
  Drug-eluting stents may demonstrate different arterial healing processes.
  
  
  METHODS
  Angioscopy was performed 9 +/- 2 months after 30 PES and 36 SES were implanted initially in the native coronary artery. Heterogeneity of the neointimal coverage (NIC) as well as the dominant grade was examined. Neointimal coverage was defined as follows: grade 0 = fully visible struts; grade 1 = struts bulged into the lumen, but covered; grade 2 = embedded, but translucent struts; grade 3 = invisible struts. Heterogeneity was judged when the NIC grade variation >or=1. Thrombi and yellow plaques (YP) were also explored.
  
  
  RESULTS
  In-stent late loss (0.44 +/- 0.44 mm vs. 0.13 +/- 0.33 mm; p < 0.0001) and dominant NIC grade (1.8 +/- 1.1 vs. 1.3 +/- 0.7; p = 0.02) were greater in PES than in SES. Of PES, 48% showed the heterogeneity of 1 grade; 26% showed that of 2 grades. Of SES, 53% showed homogeneous coverage; the remaining SES showed the heterogeneity of 1 grade; and 72% showed dominant grade 1. Thrombi were more common in PES than in SES (43% vs. 19%; p = 0.04). Both stents commonly revealed YP (83% vs. 78%; p = 0.76).
  
  
  CONCLUSIONS
  NIC was more heterogeneous in PES, associated with a higher incidence of thrombi. Homogeneous NIC may be an important factor for competent arterial healing.
authors.affiliation: Cardiovascular Division, Kansai Rosai Hospital, Amagasaki, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Awata
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Uematsu
authors.forename: Takakazu
authors.initials: T
authors.lastname: Morozumi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Watanabe
authors.forename: Toshinari
authors.initials: T
authors.lastname: Onishi
authors.forename: Osamu
authors.initials: O
authors.lastname: Iida
authors.forename: Fusako
authors.initials: F
authors.lastname: Sera
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Minamiguchi
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kotani
authors.forename: Seiki
authors.initials: S
authors.lastname: Nagata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000473:pathology; D023903:Coronary Restenosis; D003331:Coronary Vessels / Q000187:drug effects* / Q000473:pathology; D054855:Drug-Eluting Stents; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D013988:Ticlopidine / Q000627:therapeutic use
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine; D017239:Paclitaxel; D001241:Aspirin