Improved strut coverage and less late incomplete apposition with thin-strut TAXUS Liberté vs. TAXUS Express: the importance of stent platform design for drug-eluting stents.
BACKGROUND
The objective of this intravascular ultrasound (IVUS) analysis was to evaluate the vascular response of the thin-strut TAXUS Liberté stent compared with the otherwise identical TAXUS Express stent.


METHODS
The TAXUS ATLAS and TAXUS ATLAS Long Lesion studies are nonrandomized trials comparing the thin-strut TAXUS Liberté stent to historical TAXUS Express controls from the TAXUS IV and TAXUS V trials. A total of 377 patients enrolled in the two TAXUS ATLAS studies were randomly selected for the IVUS subset and compared to 314 TAXUS Express IVUS controls.


RESULTS
Despite increased lesion complexity in the TAXUS Liberté group, neointimal formation at 9 months was similar in both stents (TAXUS Liberté 13.8±11.0%; TAXUS Express 13.1±13.8%, P=.56). However, this neointima covered more of the overall stent in the TAXUS Liberté (67.9±32.5%) compared with the TAXUS Express (54.4±37.2%, P<.001), suggesting more uniform neointimal distribution. TAXUS Liberté also showed less pronounced negative remodeling at both stent edges and had significantly less (4.3% vs. 9.6%, P=.04) late incomplete stent apposition (ISA).


CONCLUSIONS
Despite identical polymer and drug release characteristic, the thin-strut TAXUS Liberté stent demonstrates improved neointimal coverage, better edge remodeling, and less late ISA vs. TAXUS Express, hereby highlighting the importance of the platform design for drug-eluting stents.
MedStar Health Research Institute, Washington Hospital Center, Washington, DC 20010, USA. neil.j.weissman@medstar.net
Neil J
NJ
Weissman
Mark A
MA
Turco
John A
JA
Ormiston
Tift
T
Mann
Louis A
LA
Cannon
Thomas F
TF
McGarry
Mark W I
MW
Webster
Jack J
JJ
Hall
Michael J
MJ
Lucca
Gregory J
GJ
Mishkel
Chiung-Jen
CJ
Wu
Lazar
L
Mandinov
Keith D
KD
Dawkins
D002317:Cardiovascular Agents / Q000008:administration & dosage; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000517:prevention & control; D023921:Coronary Stenosis / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000601:surgery; D004311:Double-Blind Method; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D011446:Prospective Studies; D011474:Prosthesis Design / Q000379:methods*; D015607:Stents; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000187:drug effects; D018084:Ultrasonography, Interventional / Q000379:methods
D002317:Cardiovascular Agents; D017239:Paclitaxel