Optical coherence tomography study of chronic-phase vessel healing after implantation of bare metal and paclitaxel-eluting self-expanding nitinol stents in the superficial femoral artery.
BACKGROUND
This study aimed to assess chronic-phase suppression of neointimal proliferation and arterial healing following paclitaxel-coated (PTX) and bare metal stent (BMS) implantation in the superficial femoral artery using optical coherence tomography (OCT).


METHODS
Twenty-five patients with 68 stents underwent an 8-month OCT follow-up. Besides standard OCT variables, neointimal characterization and frequencies of peri-strut low-intensity area (PLIA), macrophage accumulation, and in-stent thrombi were evaluated.


RESULTS
The mean neointimal thickness was significantly less with PTX stents (544.9±202.2 μm vs. 865.0±230.6 μm, p<0.0001). The covered and uncovered strut frequencies were significantly smaller and larger, respectively, in the PTX stent group vs. the BMS group (93.7% vs. 99.4%; p<0.0001, 4.0% vs. 0.4%; p<0.0001, respectively). Heterogeneous neointima was only observed in the PTX stent group (12.5% vs. 0%, p=0.017). The frequencies of PLIA and macrophage accumulation were significantly greater in the PTX stent group (87.2% vs. 67.6%, p=0.001 and 46% vs. 9.1%, p=0.003, respectively).


CONCLUSIONS
After 8 months, reduced neointimal proliferation was observed with PTX stent implantation. On the other hand, delayed arterial healing was observed compared with BMS.
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Amane
A
Kozuki
Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan. Electronic address: shinke@med.kobe-u.ac.jp.
Toshiro
T
Shinke
Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
Hiromasa
H
Otake
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Yoichi
Y
Kijima
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Tomoya
T
Masano
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Ryoji
R
Nagoshi
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Kimitake
K
Imamura
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Ryudo
R
Fujiwara
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Hiroyuki
H
Shibata
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Ryo
R
Takeshige
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Yoshiro
Y
Tsukiyama
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Kenichi
K
Yanaka
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Shinsuke
S
Nakano
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Yusuke
Y
Fukuyama
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Seinosuke
S
Kawashima
Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
Ken-ichi
K
Hirata
Osaka Saiseikai Nakatsu Hospital, Division of Cardiology, Osaka, Japan.
Junya
J
Shite
D000368:Aged; D000497:Alloys; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D006801:Humans; D008264:Macrophages / Q000378:metabolism; D008297:Male; D058426:Neointima / Q000000981:diagnostic imaging; D017239:Paclitaxel; D012189:Retrospective Studies; D015607:Stents; D041623:Tomography, Optical Coherence; D014945:Wound Healing
D000497:Alloys; C013616:nitinol; D017239:Paclitaxel
Delayed arterial healing; Drug-eluting stent; Optical coherence tomography; Peripheral artery disease