Comparison of Optical Coherence Tomographic Assessment between First- and Second-Generation Drug-Eluting Stents.
10.3349/ymj.2012.53.3.524
- Author:
Byeong Keuk KIM
1
;
Jung Sun KIM
;
Junbeom PARK
;
Young Guk KO
;
Donghoon CHOI
;
Yangsoo JANG
;
Myeong Ki HONG
Author Information
1. Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. mkhong61@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Optical coherence tomography;
stent
- MeSH:
Aged;
Coronary Angiography;
*Drug-Eluting Stents;
Female;
Humans;
Male;
Middle Aged;
Neointima/pathology/prevention & control;
Tomography, Optical Coherence/*methods
- From:Yonsei Medical Journal
2012;53(3):524-529
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: There is a lack of sufficient data in comparison of optical coherence tomographic (OCT) findings between first- and second-generation drug-eluting stents (DES). Compared to first-generation (i.e., sirolimus- or paclitaxel-eluting stents), second-generation DESs (i.e., everolimus- or biolinx-based zotarolimus-eluting stents) might have more favorable neointimal coverage. MATERIALS AND METHODS: Follow-up OCT findings of 103 patients (119 lesions) treated with second-generation DESs were compared with those of 139 patients (149 lesions) treated with first-generation DESs. The percentage of uncovered or malapposed struts, calculated as the ratio of uncovered or malapposed struts to total struts in all OCT cross-sections, respectively, was compared between the two groups. RESULTS: Both DES groups showed similar suppression of neointimal hyperplasia (NIH) on OCT (mean NIH cross-sectional area; second- vs. first-generation=1.1+/-0.5 versus 1.2+/-1.0 mm2, respectively, p=0.547). However, the percentage of uncovered struts of second-generation DESs was significantly smaller than that of first-generation DESs (3.8+/-4.8% vs.7.5+/-11.1%, respectively, p<0.001). The percentage of malapposed struts was also significantly smaller in second-generation DESs than in first-generation DESs (0.4+/-1.6% vs.1.4+/-3.7%, respectively, p=0.005). In addition, intra-stent thrombi were less frequently detected in second-generations DESs than in first-generation DESs (8% vs. 20%, respectively, p=0.004). CONCLUSION: This follow-up OCT study showed that second-generation DESs characteristically had greater neointimal coverage than first-generation DESs.
