Difference of neointimal formational pattern and incidence of thrombus formation among 3 kinds of stents: an angioscopic study.
OBJECTIVE
The purpose of this study is to compare the neointimal formational pattern and incidence of thrombus formation among sirolimus-eluting (SES), paclitaxel-eluting (PES), and bare-metal stents (BMS) with coronary angioscopy.


BACKGROUND
Neointimal formation and incidence of mural thrombus are different with the type of stent.


METHODS
One hundred successive patients who received 43 SES, 40 PES, or 32 BMS implantation underwent 6-month follow-up coronary angioscopy. We evaluated angioscopic parameters, including minimum and maximum neointimal grade; presence and number of red mural thrombus; neointimal grade around thrombus; and heterogeneity score, which is defined by subtracting minimum from maximum grade within 1 stent by classifying angioscopic neointimal coverage grades into 4 categories. We compared these parameters among 3 kinds of stent groups.


RESULTS
Heterogeneity scores of SES, PES, and BMS were 0.79 +/- 0.60, 1.27 +/- 0.75, and 1.03 +/- 0.82, respectively (p = 0.011). The PES showed the highest incidence of angioscopic red mural thrombus (50% in PES, 12% in SES, and 3% in BMS, p < 0.001), and the number of thrombus observed within 1 stent in the PES group tended to be larger than those in the SES and BMS groups.


CONCLUSIONS
At 6 months after stent implantation, PES showed the most heterogeneous neointimal formation and the highest incidence of thrombus formation compared with SES and BMS.
Hara
Masahiko
M
Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan. wpgjq774@yahoo.co.jp
Nishino
Masami
M
Taniike
Masayuki
M
Makino
Nobuhiko
N
Kato
Hiroyasu
H
Egami
Yasuyuki
Y
Shutta
Ryu
R
Yamaguchi
Hitoshi
H
Tanouchi
Jun
J
Yamada
Yoshio
Y
D000368:Aged; D017546:Angioscopy; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use; D012307:Risk Factors; D020123:Sirolimus / Q000627:therapeutic use; D015607:Stents; D013997:Time Factors
D000972:Antineoplastic Agents, Phytogenic; D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus