title: Time-related changes in neointimal tissue coverage of a novel Sirolimus eluting stent: Serial observations with optical coherence tomography.
abstract: BACKGROUND
  DES has reduced rates of restenosis compared with BMS but it has been associated with delayed healing and increase of stent thrombosis. The aim of our study was to evaluate the vascular time-related changes following implantation of a new SES coated with an amorphous silicon carbide that allows faster re-endothelisation (Orsiro-Biotronik).
  
  
  METHODS
  This prospective registry enrolled STEMI-patients with multi-vessel disease, thus candidates for a two-step procedure. PCI of the culprit lesion was performed with at least one Orsiro stent that was OCT-analysed during the second-step procedure (deferred to 30,90 and 180-days).
  
  
  RESULTS
  16 of the 95 patients with MVD underwent an OCT evaluation of the study device implanted in the culprit lesion during the second-step staged procedure and were enrolled in the present Registry. A total of 3060-struts were analysed. The percentage of uncovered struts was 19.6% at30-days, 1.3% at90-days and 1.8% at180-days (p<0.001). The percentage of cross section with ≥1 uncovered struts were 51.3% at30-days, 6.5% at90-days and 5.7% at180-days (p<0.001). The percentage of cross sections containing thrombus was 6.2% at30-days while no thrombus was detected both at90 and 180-days.
  
  
  CONCLUSIONS
  Our data shows that the new Orsiro stent promotes early and persistent strut coverage with low peri-strut thrombus. This pilot OCT evaluation might suggest a low incidence of late adverse events and anticipate safe outcome after early withdrawal of dual antiplatelet therapy.
authors.affiliation: Interventional Cardiology, "Santi Antonio e Biagio e Cesare Arrigo" Hospital, Alessandria, Italy; NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK. Electronic address: gioel.gabrio.secco@gmail.com.
authors.forename: Gioel Gabrio
authors.initials: GG
authors.lastname: Secco
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK.
authors.forename: Alessio
authors.initials: A
authors.lastname: Mattesini
authors.affiliation: Interventional Cardiology, "San Salvatore" Hospital, Pesaro, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Fattori
authors.affiliation: Interventional Cardiology, "San Salvatore" Hospital, Pesaro, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Parisi
authors.affiliation: GVM Care and Research, Cotignola, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Castriota
authors.affiliation: Interventional Cardiology, "Santi Antonio e Biagio e Cesare Arrigo" Hospital, Alessandria, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Vercellino
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK.
authors.forename: Gianni
authors.initials: G
authors.lastname: Dall'Ara
authors.affiliation: Interventional Cardiology, "San Salvatore" Hospital, Pesaro, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Uguccioni
authors.affiliation: Interventional Cardiology, "San Salvatore" Hospital, Pesaro, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Marinucci
authors.affiliation: University of Eastern Piedmont, Novara, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Luca
authors.affiliation: University of Eastern Piedmont, Novara, Italy.
authors.forename: Paolo Nicola
authors.initials: PN
authors.lastname: Marino
authors.affiliation: Interventional Cardiology, "Santi Antonio e Biagio e Cesare Arrigo" Hospital, Alessandria, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Pistis
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
mesh_terms: D000368:Aged; D023903:Coronary Restenosis / Q000517:prevention & control; D023921:Coronary Stenosis / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D058426:Neointima; D011446:Prospective Studies; D011474:Prosthesis Design; D020123:Sirolimus / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D041623:Tomography, Optical Coherence
chemical_list: D020123:Sirolimus
keywords: Early endothelisation; OCT; Orsiro DES; Strut coverage