Differences in Vessel Healing Between Sirolimus- and Everolimus-Eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE Optical Coherence Tomography Substudy.
BACKGROUND
We aimed to clarify the differences in vessel healing after stenting of bifurcation lesions using sirolimus-eluting stents (SESs) or everolimus-eluting stents (EESs).


METHODS
Japanese Registry Study in Comparison Between Everolimus-Eluting Stent and Sirolimus-Eluting Stent for the Bifurcation Lesion (J-REVERSE) is a prospective multicentre registry of 303 bifurcation lesions that were treated with provisional SES or EES with or without final kissing inflation. The first 115 lesions at selected study sites were predefined for inclusion in the optical coherence tomography (OCT) substudy, and 9-month follow-up OCT was conducted in 64 lesions (SES, n = 18; EES, n = 46). In addition to standard OCT parameters, stent eccentricity index (SEI; minimum divided by the maximum stent diameter), neointimal unevenness score (NUS; maximum neointimal thickness in the cross-section [CS] divided by the average neointimal thickness [NIT] of the same CS; uniformity of the neointima suppression) were averaged for each segment (proximal, bifurcation, and distal segments).


RESULTS
Overall, the average stent and luminal area, NIT, and frequency of uncovered struts were similar. The frequency of malapposed struts and SEI were significantly lower in the EES group than in the SES group. The EES group had a significantly smaller NUS in the proximal and distal segments.


CONCLUSIONS
EESs offer homogeneous vessel healing with less malapposition in the treatment of bifurcation lesions.
Department of Cardiovascular Medicine, Kobe University, Kobe, Japan.
Daisuke
D
Terashita
Department of Cardiovascular Medicine, Kobe University, Kobe, Japan.
Hiromasa
H
Otake
Department of Cardiovascular Medicine, Kobe University, Kobe, Japan. Electronic address: shinke@med.kobe-u.ac.jp.
Toshiro
T
Shinke
Clinical Research Institute, Kyushu Medical Center, Fukuoka, Japan; Department of Cardiology, Cardiovascular Center, Kyushu Medical Center, Fukuoka, Japan; Department of Cardiovascular Medicine, New Yukuhashi Hospital, Yukuhashi, Japan.
Yoshinobu
Y
Murasato
Department of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan.
Yoshihisa
Y
Kinoshita
Department of Cardiovascular Medicine, Saiseikai Yokohama-Eastern Hospital, Yokohama, Japan.
Masahiro
M
Yamawaki
Department of Cardiovascular Medicine, Rinku General Medical Center, Izumi-Sano, Japan.
Yoshihiro
Y
Takeda
Department of Cardiovascular Medicine, Hyogo Medical University, Nishinomiya, Japan.
Kenichi
K
Fujii
Department of Cardiovascular Medicine, Himeji Cardiovascular Center, Himeji, Japan.
Shin-Ichiro
S
Yamada
Department of Cardiovascular Medicine, Shiroyama Hospital, Habikino, Japan.
Yoshihisa
Y
Shimada
Department of Cardiovascular Medicine, Cardiovascular Center Hokkaido Ono Hospital, Sapporo, Japan.
Takehiro
T
Yamashita
Department of Cardiovascular Medicine, Yokohama Rosai Hospital, Yokohama, Japan.
Kazuhiko
K
Yumoto
Department of Cardiovascular Medicine, Kobe University, Kobe, Japan.
Ken-Ichi
K
Hirata
D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000473:pathology* / Q000601:surgery; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D020123:Sirolimus / Q000494:pharmacology*; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000379:methods*
D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus