Long-term (≥2 years) follow-up optical coherence tomographic study after sirolimus- and paclitaxel-eluting stent implantation: comparison to 9-month follow-up results.
Many studies have demonstrated that late or very late thrombosis after drug-eluting stent (DES) implantation may be related with incomplete neointimal coverage. We investigated long-term (≥2 years) results of neointimal coverage following sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) implantation using optical coherence tomography (OCT). A follow-up angiography with OCT examination was performed in 29 patients with 32 lesions for more than 2 years (group 1; 1,066 ± 381 days) and 101 patients with 104 lesions at 9 months (group 2; 273 ± 33 days) after the index procedure. The status of neointimal coverage and stent apposition was evaluated. The number of stents with completely covered struts was higher (25.0% in group 1 vs. 13.5% in group 2, P = 0.12). The percentage of uncovered struts (5.4 ± 7.5% in group 1 vs. 8.5 ± 11.6% in group 2, P = 0.19) and that of malapposed strut (0.5 ± 1.4% vs. 1.5 ± 4.2%, respectively, P = 0.19) were lower in group 1. While the percentage of uncovered and malapposed struts were quite similar in the PES groups between the two groups (P = 0.54 and 0.65, respectively), there were lower trends in the percentage of uncovered and malapposed struts in the SES group (P = 0.09 and 0.09, respectively). In conclusion, incomplete neointimal coverage was still observed in a majority of DESs and considerable struts were not covered with neointima even at more than 2 years after DES implantation. The pattern of neointimal coverage between 9-month and 2-year appeared to be somewhat different between PES and SES.
Division of Cardiology, Severance Cardiovascular Center, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, Seoul, 120-752, Korea.
Tae-Hoon
TH
Kim
Jung-Sun
JS
Kim
Byoung-Keuk
BK
Kim
Young-Guk
YG
Ko
Donghoon
D
Choi
Yangsoo
Y
Jang
Myeong-Ki
MK
Hong
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000209:etiology; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D056910:Republic of Korea; D020123:Sirolimus / Q000008:administration & dosage*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D017239:Paclitaxel; D020123:Sirolimus