title: Comparison of vascular responses after different types of second-generation drug-eluting stents implantation detected by optical coherence tomography.
abstract: Few studies have directly compared vascular responses to second-generation drug-eluting stents (DESs). We performed optical coherence tomography examinations in 56 consecutive patients with implanted single stent [19 cobalt-chromium everolimus-eluting stents (CoCr-EES), 22 platinum-chromium EES (PtCr-EES), and 15 resolute zotarolimus-eluting stents (R-ZES)] for de novo lesions, and who did not have restenosis at their 9-month follow-up. Neointimal thickness (NIT), stent apposition, and neointimal coverage were assessed in every strut. A neointimal unevenness score [(NUS), maximum NIT/average NIT in the same cross-section] was determined for every 1-mm cross-section (CS). A total of 8350 struts and 1159 CSs were analyzed. The CoCr- and PtCr-EES had significantly fewer malapposed struts compared to the R-ZES (CoCr-EES: 0.19 % vs. PtCr-EES: 0.19 % vs.
  0.61 %, p = 0.007). Furthermore, the PtCr-EES had a lower frequency of uncovered struts compared to the others (CoCr-EES: 2.0 % vs. PtCr-EES: 1.4 % vs.
  2.3 %, p = 0.047). The NUS correlated with the frequency of uncovered struts (p < 0.001, r = 0.54). The EESs demonstrated more homogenous neointimal growth, as shown in the NUS, compared to the R-ZES [CoCr-EES: 1.66 (1.38-1.97) vs. PtCr-EES: 1.67 (1.41-2.00) vs.
  1.94 (1.56-2.28), p < 0.001]. Our results demonstrate that unevenness neointimal growth may relate with strut coverage after second-generation DES implantation. The PtCr-EES had a high frequency of strut coverage with a homogeneous neointima, suggesting fewer risks for stent thrombosis.
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ohtani
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan. shigeki55@nifty.com.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Kimura
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Tomoyo
authors.initials: T
authors.lastname: Sugiyama
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Hishikari
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Misawa
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Mizusawa
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Hayasaka
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Yamakami
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kojima
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Sagawa
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hikita
authors.affiliation: Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ashikaga
authors.affiliation: Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Isobe
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000009:adverse effects; 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* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D058426:Neointima; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D008670:Metals; D000068338:Everolimus; C489443:zotarolimus; D020123:Sirolimus
keywords: Neointimal hyperplasia; Optical coherence tomography; Second-generation drug-eluting stent; Strut coverage