Comparisons of the effects of stent eccentricity on the neointimal hyperplasia between sirolimus-eluting stent versus paclitaxel-eluting stent.
OBJECTIVE
Previous studies suggested that asymmetric stent expansion did not affect suppression of neointimal hyperplasia (NIH) after sirolimus-eluting stents (SES) implantation. The aim of this study was to evaluate the effects of stent eccentricity (SE) on NIH between SES versus paclitaxel-eluting stents (PES) using an intravascular ultrasound (IVUS) analysis from the randomized trial.


METHODS
Serial IVUS data were obtained from Post-stent Optimal Expansion (POET) trial, allocated randomly to SES or PES. Three different SE (minimum stent diameter divided by maximum stent diameter) were evaluated; SE at the lesion site with maximal %NIH area (SE-NIH), SE at the minimal stent CSA [SE-minimal stent area (SE-MSA)], and averaged SE through the entire stent (SE-mean). We classified each drug-eluting stents (DES) into the concentric (≥ mean SE) and eccentric groups (< mean SE) based on the mean value of SE.


RESULTS
Among 301 enrolled patients, 233 patients [SES (n = 108), PES (n = 125)] underwent a follow-up IVUS. There was no significant correlation between %NIH area and SE-NIH (r = - 0.083, p = 0.391) or SE-MSA (r = - 0.109, p = 0.259) of SES. However, SE-NIH of PES showed a weak but significant correlation with %NIH area (r = 0.269, p < 0.01). As to the associations between SEmean and NIH volume index, SES revealed no significant correlation (r = - 0.001, p = 0.990), but PES showed a weak but significant correlation (r = 0.320, p < 0.01). However, there was no difference in the restenosis rate between the eccentric versus concentric groups of both DES.


CONCLUSIONS
This study suggests that lower SE of both SES and PES, which means asymmetric stent expansion, may not be associated with increased NIH.
Kim
Byeong-Keuk
BK
Division of Cardiology, Cardiovascular Center, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
Ko
Young-Guk
YG
Oh
Seungjin
S
Kim
Jung-Sun
JS
Kang
Woong Chol
WC
Jeon
Dong Woon
DW
Yang
Joo Young
JY
Choi
Donghoon
D
Hong
Myeong-Ki
MK
Ahn
Taehoon
T
Jang
Yangsoo
Y
D000368:Aged; D000792:Angiography / Q000379:methods; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000473:pathology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000188:drug therapy* / Q000473:pathology; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D020123:Sirolimus / Q000008:administration & dosage*; D017539:Tunica Intima; D018084:Ultrasonography, Interventional / Q000379:methods
D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus