Coronary angioscopic findings 9 months after everolimus-eluting stent implantation compared with sirolimus-eluting stents.
OBJECTIVE
We assessed angioscopic findings after everolimus-eluting stents (EES) implantation, compared with sirolimus-eluting stents (SES).


BACKGROUND
Coronary angioscopy (CAS) provides an opportunity to assess neointimal coverage over stent struts, thrombus, and plaque color by direct visualization. CAS is a useful tool for evaluating stent struts after drug-eluting stent implantation. Angioscopic findings after EES implantation have not been reported before.


METHODS
We performed CAS in 23 patients who were treated with EES and 41 patients with SES. CAS was performed 8.5 months after stent implantation. We assessed neointimal coverage, thrombus, and plaque color. We classified neointimal coverage in 4 grades: grade 0=struts were completely exposed; grade 1=struts were visible with dull light reflexion; grade 2=there was no light reflexion from slightly visible struts; grade 3=struts were completely covered.


RESULTS
There was no significant difference in minimum, maximum, dominant grade of neointimal coverage, and heterogeneity index between EES and SES. Thrombus was less frequently observed in EES than SES (4% vs 29%, p=0.02). When we divided study patients into acute coronary syndrome (ACS) or stable angina pectoris (SAP), there was a tendency toward less thrombus in EES than SES, in both ACS and SAP. Maximum color grade of the plaques was less advanced in EES than SES (p<0.01). Yellow plaques of grade 2 or 3 were less frequent in EES than SES (35% vs 76%, p<0.01).


CONCLUSIONS
This study suggested that EES were associated with lower risk of thrombus formation than SES.
Department of Cardiology, Hiroshima City Hospital, Hiroshima, Japan.
Kazuoki
K
Dai
Masaharu
M
Ishihara
Ichiro
I
Inoue
Takuji
T
Kawagoe
Yuji
Y
Shimatani
Fumiharu
F
Miura
Yasuharu
Y
Nakama
Takayuki
T
Otani
Kuniomi
K
Ooi
Hiroki
H
Ikenaga
Masayuki
M
Nakamura
Takashi
T
Miki
Shinji
S
Kishimoto
Yoji
Y
Sumimoto
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D020677:Angioscopes; D003324:Coronary Artery Disease / Q000473:pathology* / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology / Q000517:prevention & control; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D000068338:Everolimus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D013997:Time Factors
D000068338:Everolimus; D020123:Sirolimus