title: Impact of arterial injury on neointimal hyperplasia after implantation of drug-eluting stents in coronary arteries: an intravascular ultrasound study.
abstract: OBJECTIVE
  We investigated the impact of arterial injury on neointimal hyperplasia following implantation of drug-eluting stents (DES).
  
  
  RESULTS
  A total of 196 patients with 223 segments (sirolimus-eluting stents [SES]: 104, paclitaxel-eluting stents [PES]: 119) underwent intravascular ultrasound eight months after DES implantation. Arterial injury was defined as the balloon-to-artery ratio (BAR). Segments were categorised into two groups: high BAR defined as BAR>1.1 (120 segments), and low BAR defined as BAR < or =1.1 (103 segments). Baseline clinical characteristics were similar for both groups. Although reference vessel diameter was smaller, stent diameter, maximal balloon pressure and balloon diameter were higher in the high BAR compared with the low BAR group. Lumen (7.10±1.91 vs. 6.25±1.69, p=0.001), stent (7.31±1.95 vs. 6.41±1.80, p=0.001), and external elastic membrane (17.1±4.9 vs. 14.8±4.0, p<0.0001) areas (mm2) were higher, but neointimal hyperplasia (0.21±0.36 vs. 0.16±0.48, p=0.42) area (mm2) was similar in the high BAR compared with the low BAR group. Arterial injury as assessed by BAR was not associated with the amount of neointimal hyperplasia (R2=0.003, p=0.40).
  
  
  CONCLUSIONS
  Arterial injury does not correlate with the amount of neointimal hyperplasia following DES implantation. Conventionally aggressive DES implantation techniques do not adversely affect long-term outcome with respect to restenosis.
authors.affiliation: Department of Cardiology, Bern University Hospital, Switzerland.
authors.forename: Parham
authors.initials: P
authors.lastname: Eshtehardi
authors.forename: Stéphane
authors.initials: S
authors.lastname: Cook
authors.forename: Simon
authors.initials: S
authors.lastname: Wandel
authors.forename: Lorenz
authors.initials: L
authors.lastname: Räber
authors.forename: Peter
authors.initials: P
authors.lastname: Wenaweser
authors.forename: Mario
authors.initials: M
authors.lastname: Togni
authors.forename: Rolf
authors.initials: R
authors.lastname: Vogel
authors.forename: Ali
authors.initials: A
authors.lastname: Garachemani
authors.forename: Franz R
authors.initials: FR
authors.lastname: Eberli
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Peter
authors.initials: P
authors.lastname: Jüni
authors.forename: Otto M
authors.initials: OM
authors.lastname: Hess
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meier
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000818:Animals; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D020123:Sirolimus / Q000008:administration & dosage; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D017239:Paclitaxel; D020123:Sirolimus