Optical coherence tomographic observations of polytetrafluoroethylene-covered sirolimus-eluting coronary arterial stent.
The aim of this study was to evaluate neointimal coverage obtained using a new method of polytetrafluoroethylene-covered stent (PCS) implantation combined with underlying longer sirolimus-eluting stent (SES) implantation using optical coherence tomography. Nine patients were enrolled in this study, including patients with coronary artery perforations, original coronary aneurysms, and acquired coronary aneurysms after drug-eluting stent implantation. All patients were first treated with long SES implantation and then with focal PCS implantation. Postprocedural and follow-up angiographic and optical coherence tomographic examinations were performed in all patients, and intravascular ultrasound was performed in 5 patients. All patients were asymptomatic during follow-up, without recurrent angina. There was no stent-edge or stent-segment binary restenosis. Values of late loss for proximal SES segments, PCS segments, and distal SES segments were similar (0.09, 0.07, and 0.04 mm, respectively, p = 0.8113). The mean neointimal thickness of PCS was less than that of proximal and distal SES. However, no malapposed cross sections or uncovered cross sections were found in PCS segments compared with SES segments (p = 0.0011). In conclusion, the combination of PCS and underlying longer SES implantation can offer better angiographic follow-up results. High-resolution optical coherence tomography provided convincing proof of full neointimal coverage of PCS. This new method of combined PCS and SES implantation may be a better choice compared with direct PCS implantation in certain clinical settings.
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, and The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
Jingbo
J
Hou
Haibo
H
Jia
Xingtao
X
Huang
Huai
H
Yu
Xuefeng
X
Ren
Yan
Y
Fang
Zhigang
Z
Han
Shuang
S
Yang
Lingbo
L
Meng
Shaosong
S
Zhang
Bo
B
Yu
Ik-Kyung
IK
Jang
D002317:Cardiovascular Agents / Q000008:administration & dosage; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D054855:Drug-Eluting Stents; D006801:Humans; D058426:Neointima; D011138:Polytetrafluoroethylene; D011857:Radiographic Image Interpretation, Computer-Assisted; D020123:Sirolimus / Q000008:administration & dosage*; D018709:Statistics, Nonparametric; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D002317:Cardiovascular Agents; D011138:Polytetrafluoroethylene; D020123:Sirolimus