Optical coherence evaluation of everolimus-eluting stents 8 months after implantation.
OBJECTIVE
The aim of this study was to evaluate detailed vessel response after everolimus-eluting stents (EES) implantation in human de novo coronary lesions by optical coherence tomography (OCT).


METHODS
Between November 2008 and October 2009, 25 patients (14 men, 65.5±8.6 years) with de novo native coronary artery lesions were implanted with 30 EES, and OCT was performed at 8 months post-implantation.


METHODS
Neointimal thickness (NIT) on each strut, strut apposition to the vessel wall, the frequency of struts surrounded by low intensity area and the incidence of intra-stent thrombus were analysed. To evaluate the radial unevenness of NIT, the difference between the maximum and minimum NIT (dNT) was calculated for each cross-section.


RESULTS
At 236±39 days after implantation, there were no major adverse cardiac events, nor target vessel revascularisation. A total of 5,931 struts was evaluated by OCT. The median NIT was 80 μm (25th and 75th percentile 50 μm and 140 μm) and average NIT was 100±74 μm. The number of neointima-covered struts was 5,834 (98.4%), and 31 (0.52%) struts showed malapposition without neointimal coverage. The number of struts surrounded by low intensity area was 452 (7.62%). Eleven EES (37%) showed full neointimal coverage. No intra-stent thrombus was detected. The average dNT was 108±77 μm.


CONCLUSIONS
Most EES struts were covered with uniform and thin neointima. The frequency of low-intensity neointima was very low, which may be a result of promoted vessel healing. These results may support improved clinical outcomes with EES in clinical trials.
Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
Takumi
T
Inoue
Junya
J
Shite
Junghan
J
Yoon
Toshiro
T
Shinke
Hiromasa
H
Otake
Takahiro
T
Sawada
Hiroyuki
H
Kawamori
Hiroki
H
Katoh
Naoki
N
Miyoshi
Naoki
N
Yoshino
Amane
A
Kozuki
Hirotoshi
H
Hariki
Ken-Ichi
K
Hirata
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000628:therapy; D023903:Coronary Restenosis / Q000175:diagnosis*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000175:diagnosis*; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D013997:Time Factors; D041623:Tomography, Optical Coherence
D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus