Comparison by optical coherence tomography of paclitaxel-eluting stents with sirolimus-eluting stents implanted in one coronary artery in one procedure. - 6-month follow-up -.
BACKGROUND
Differences between paclitaxel-eluting stents (PES) and sirolimus-eluting stent (SES) in neointimal proliferation under strictly matched conditions remain to be clarified by optical coherence tomography (OCT).


RESULTS
Between May and December 2007, 27 patients were implanted with a PES and a SES, randomized to either the proximal or distal site in a single coronary artery, and underwent follow-up angiography and OCT examination at 6 months. The frequency of vessel wall apposition with neointima was greater for PES than for SES (92.6% vs 85.8%, P<0.01). The median (25th, 75th percentiles) neointimal thickness (NIT) in PES was significantly greater than that in SES (90 microm [25th: 40 microm; 75th: 200 microm] vs 50 microm [25th: 20 microm; 75th: 140 microm]; P<0.01). Both the average difference between the maximum and minimum NIT in each cross-section and the average difference between the maximum and minimum NIT in the longitudinal axis were larger in PES than in SES (206+/-88 vs 131+/-57 microm; P<0.001, 607+/-243 vs 400+/-185 microm; P<0.001). Low-density spots were significantly more frequently observed in PES than in SES (30.9% vs 17.0%, P=0.001).


CONCLUSIONS
Compared with SES, PES had a non-uniform and larger neointimal thickness with fewer uncovered struts, and more peri-strut low-density areas.
Miyoshi
Naoki
N
Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Shite
Junya
J
Shinke
Toshiro
T
Otake
Hiromasa
H
Tanino
Yusuke
Y
Ogasawara
Daisuke
D
Sawada
Takahiro
T
Kawamori
Hiroyuki
H
Kato
Hiroki
H
Yoshino
Naoki
N
Kozuki
Amane
A
Hirata
Ken-ichi
K
D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000494:pharmacology*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000494:pharmacology*; D020123:Sirolimus / Q000494:pharmacology*; D041623:Tomography, Optical Coherence; D050257:Tubulin Modulators / Q000494:pharmacology*; D017539:Tunica Intima / Q000473:pathology*
D000903:Antibiotics, Antineoplastic; D050257:Tubulin Modulators; D017239:Paclitaxel; D020123:Sirolimus