title: Six-month follow-up evaluation for everolimus-eluting stents by intracoronary optical coherence tomography: comparison with paclitaxel-eluting stents.
abstract: BACKGROUND
  Although several clinical trials have shown the superior efficacy and safety of second-generation everolimus-eluting stents (EES) in comparison with first-generation paclitaxel-eluting stents (PES), the differences in the vascular healing process between EES and PES in a human coronary artery during an early stage are unknown.
  
  
  METHODS
  A prospective optical coherence tomography (OCT) observation was performed for 25 EES in 21 patients and 27 PES in 21 patients at 6 months after implantation. Cross-sections within single-stent segments were analyzed at intervals of 1mm. The neointimal (NI) thickness on each strut was measured. Uncovered struts (NI thickness=0 μm), malapposed struts, NI area (%), uncovered strut ratio >0.3 (UCSR; number of uncovered struts/number of total struts) per cross-section, and in-stent thrombus were evaluated.
  
  
  RESULTS
  A total of 5198 EES struts in 514 cross-sections and 4243 PES struts in 469 cross-sections were identified. NI thickness and its area were smaller for EES than PES (80.0 ± 84.8 μm vs. 117.9 ± 140.0 μm and 19.1 ± 8.9% vs. 23.7 ± 11.5%, respectively; P<0.001). The frequencies of uncovered struts and malapposed struts were lower in EES compared to PES (2.3% vs. 5.2% and 2.1% vs. 5.7%, respectively; P<0.001). Patients who had cross-sections of UCSR >0.3 and thrombi were identified less frequently in EES than in PES group (5% vs. 57%; P<0.001, and 19% vs. 48%; P=0.05, respectively).
  
  
  CONCLUSIONS
  Six-month OCT examination showed a favorable vessel healing response after the implantation of EES, demonstrating less in-stent late loss as well as fewer uncovered struts and better stent apposition to the vessel wall in comparison with PES.
authors.affiliation: Cardiovascular Center, Chiba-Hokusoh Hospital, Nippon Medical School, Chiba, Japan. takanom@nms.ac.jp
authors.forename: Masamichi
authors.initials: M
authors.lastname: Takano
authors.forename: Daisuke
authors.initials: D
authors.lastname: Murakami
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamamoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Kurihara
authors.forename: Koji
authors.initials: K
authors.lastname: Murai
authors.forename: Toru
authors.initials: T
authors.lastname: Inami
authors.forename: Nakahisa
authors.initials: N
authors.lastname: Kimata
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohba
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Seino
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Mizuno
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000187:drug effects; D054855:Drug-Eluting Stents / Q000592:standards; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011446:Prospective Studies; D011859:Radiography; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000639:trends*; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus