Comparison of Sirolimus and Paclitaxel-Eluting Stents for Complex Coronary Lesions: An Intravascular Ultrasound Study.
10.3904/kjim.2009.24.4.323
- Author:
Yun Kyeong CHO
1
;
Seung Ho HUR
;
Hyun Tae KIM
;
In Cheol KIM
;
Hyoung Seob PARK
;
Hyuck Jun YOON
;
Chang Wook NAM
;
Hyungseop KIM
;
Seong Wook HAN
;
Yoon Nyun KIM
;
Kwon Bae KIM
Author Information
1. Division of Cardiology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea. shur@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Coronary artery disease;
Drug-eluting stents;
Ultrasonography
- MeSH:
Adult;
Aged;
Coronary Angiography;
Coronary Artery Disease/radiography/*therapy/ultrasonography;
*Drug-Eluting Stents/adverse effects;
Female;
Follow-Up Studies;
Humans;
Hyperplasia;
Male;
Middle Aged;
Paclitaxel/*administration & dosage;
Sirolimus/*administration & dosage;
Tunica Intima/pathology;
Ultrasonography, Interventional/*methods
- From:The Korean Journal of Internal Medicine
2009;24(4):323-329
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Recent intravascular ultrasound (IVUS) studies of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) have demonstrated a significant reduction in neointimal hyperplasia (NIH) based on simple coronary lesions. In this study, we evaluated the efficacy of SES and PES using IVUS in complex coronary lesions. METHODS: Eighty-seven patients in whom 95 drug-eluting stents (66 SES and 29 PES) were implanted in complex coronary lesions were enrolled in this study. Case selection was based on the availability of IVUS and quantitative coronary angiographic (QCA) examinations at the index procedure and at follow-up. The neointimal volume index (volume/length: NIVI) and percent neointimal volume (% NIV) were calculated. The longitudinal length of stented segments without IVUS-detectable NIH was also evaluated. RESULTS: The baseline patient demographics were similar between the SES and PES groups. At follow-up, no significant differences were observed in the vessel, plaque, or stent volume indices between the two groups. However, the NIVI and % NIV were significantly lower in the SES group (p<0.01). The longitudinal length of stented segments without IVUS-detectable NIH was significantly higher in the SES group (p<0.01). The net gain was significantly larger in the SES group (2.3+/-0.7 vs. 2.0x0.6 mm, p=0.025), while the rate of major adverse cardiac events was similar between the two groups. CONCLUSIONS: Although SES showed significantly greater suppression of NIH at follow-up, both stents were highly effective at inhibiting NIH in complex coronary lesions.
