title: Overtime evaluation of the vascular HEALing process after everolimus-eluting stent implantation by optical coherence tomography. The HEAL-EES study.
abstract: OBJECTIVE
  Second-generation drug-eluting stent (DES) have shown a better safety and efficacy as compared to first generation DES due to an improved vascular healing process. This process has not been so far evaluated in vivo in an overtime fashion by optical coherent tomography (OCT). We sought to evaluate the vascular healing process after everolimus-eluting stent (EES) implantation at 6, 9 and 12months, by OCT.
  
  
  METHODS
  Consecutive 36 patients undergoing percutaneous coronary intervention with EES were randomized 1:1:1 to receive OCT imaging at 6 (group A), 9 (group B) or 12-month follow-up (group C). One patient from group C was excluded because of target lesion revascularization at 1-month, whereas 5 patients withdraw the informed consent. Finally, 30 patients were analyzed.
  
  
  RESULTS
  Neointimal thickness was not different between 3 groups (group A: 99.50 [94.06-127.79] μm, group B: 107.26 [83.48-133.59] μm, group C: 127.67 [102.51-138.49] μm; p=0.736). Although the percentage of "uncovered struts" was significantly higher in group A as compared to the other groups (8.0% vs. 4.4% vs. 2.9%, respectively; p=0.180), the ratio of uncovered to total struts per section <30% was similar between 3 groups (0.3% vs. 0.3% vs. 0%, respectively; p=1.000).
  
  
  CONCLUSIONS
  Healing process following EES implantation seems almost completed at 6-month follow-up. These data, which need to be confirmed in a larger study, may support the decision to shorten dual antiplatelet therapy.
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: Shuji
authors.initials: S
authors.lastname: Otsuki
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain. Electronic address: sabrugal@clinic.ub.es.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Sabaté
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Shiratori
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: Omar
authors.initials: O
authors.lastname: Gomez-Monterrosas
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: Giancarla
authors.initials: G
authors.lastname: Scalone
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Romero-Villafañe
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: Marco
authors.initials: M
authors.lastname: Hernández-Enríquez
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Freixa
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Martín-Yuste
authors.affiliation: Thorax Institute, Department of Cardiology, Hospital Clinic, IDIBAPS, University of Barcelona, Spain.
authors.forename: Mónica
authors.initials: M
authors.lastname: Masotti
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058426:Neointima; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D013030:Spain; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D002317:Cardiovascular Agents; D000068338:Everolimus
keywords: Optical coherence tomography; everolimus-eluting stent; vascular healing