Optical coherence tomography analysis of strut coverage in biolimus- and sirolimus-eluting stents: 3-month and 12-month serial follow-up.
BACKGROUND
No randomized studies have been conducted to investigate serial changes in optical coherence tomography (OCT) analyses following implantation of biolimus-A9-eluting stents (BES) and sirolimus-eluting stents (SES).


METHODS
A total of 60 patients fulfilling the study criteria were randomly assigned into BES (n=30) and SES (n=30) implantation groups. Serial OCT evaluation at post-procedure, 3- and 12-month follow-up was performed in 46 patients [BES (n=22) and SES (n=24)]. OCT analyses were compared according to the type of stents and the follow-up time intervals. The percentage of uncovered struts was defined as the ratio of uncovered struts to total struts in all cross-sections. The primary endpoint was the percentage change (Δ) of uncovered struts in the 3- and 12-month follow-up samples.


RESULTS
The percentage of uncovered struts at the 3-month time period was not significantly different in the BES and SES groups; the median value (interquartile range) was 14.7% (0.0-23.4) versus 8.6% (0.7-21.5) (p=0.98), respectively. However, OCT at the 12-month follow-up showed a significantly lower percentage of uncovered struts [2.6% (0.8-5.6) versus 6.2% (1.7-14.7), (p=0.028), respectively] without significant difference of neointimal thickness. BES showed a greater reduction of percentage Δ of uncovered struts from 3-12 months than that of SES [-17.2±14.5% versus -7.7±16.3%, respectively (p=0.043)].


CONCLUSIONS
Both drug-eluting stents showed a high percentage of incomplete strut coverage at 3 months. However, BES showed a significantly lower percentage of uncovered struts at 12 months compared to that of SES. This was achieved by superior strut coverage from 3 to 12 months.
Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Byeong-Keuk
BK
Kim
Myeong-Ki
MK
Hong
Dong-Ho
DH
Shin
Jung-Sun
JS
Kim
Young-Guk
YG
Ko
Donghoon
D
Choi
Yangsoo
Y
Jang
D000972:Antineoplastic Agents, Phytogenic / Q000494:pharmacology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology* / Q000601:surgery; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000494:pharmacology*; D011446:Prospective Studies; D011474:Prosthesis Design; D015203:Reproducibility of Results; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000494:pharmacology; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D017539:Tunica Intima / Q000473:pathology
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel; C518022:umirolimus; D020123:Sirolimus
Coronary artery disease; Drug-eluting stent; Optical coherence tomography