Comparisons of the Effects of Stent Eccentricity on the Neointimal Hyperplasia between Sirolimus-Eluting Stent versus Paclitaxel-Eluting Stent.
10.3349/ymj.2010.51.6.823
- Author:
Byeong Keuk KIM
1
;
Young Guk KO
;
Seungjin OH
;
Jung Sun KIM
;
Woong Chol KANG
;
Dong Woon JEON
;
Joo Young YANG
;
Donghoon CHOI
;
Myeong Ki HONG
;
Taehoon AHN
;
Yangsoo JANG
Author Information
1. Division of Cardiology, Cardiovascular Center, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
- Publication Type:Original Article ; Comparative Study ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Drug-eluting stents;
intravascular ultrasonography;
restenosis
- MeSH:
Aged;
Angiography/methods;
Coronary Restenosis/pathology/ultrasonography;
*Drug-Eluting Stents;
Female;
Humans;
Hyperplasia/*drug therapy/pathology;
Immunosuppressive Agents/administration & dosage;
Male;
Middle Aged;
Paclitaxel/*administration & dosage;
Sirolimus/*administration & dosage;
Tunica Intima;
Ultrasonography, Interventional/methods
- From:Yonsei Medical Journal
2010;51(6):823-831
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Previous studies suggested that asymmetric stent expansion did not affect suppression of neointimal hyperplasia (NIH) after sirolimus-eluting stents (SES) implantation. The aim of this study was to evaluate the effects of stent eccentricity (SE) on NIH between SES versus paclitaxel-eluting stents (PES) using an intravascular ultrasound (IVUS) analysis from the randomized trial. MATERIALS AND METHODS: Serial IVUS data were obtained from Post-stent Optimal Expansion (POET) trial, allocated randomly to SES or PES. Three different SE (minimum stent diameter divided by maximum stent diameter) were evaluated; SE at the lesion site with maximal %NIH area (SE-NIH), SE at the minimal stent CSA [SE-minimal stent area (SE-MSA)], and averaged SE through the entire stent (SE-mean). We classified each drug-eluting stents (DES) into the concentric (> or = mean SE) and eccentric groups (< mean SE) based on the mean value of SE. RESULTS: Among 301 enrolled patients, 233 patients [SES (n = 108), PES (n = 125)] underwent a follow-up IVUS. There was no significant correlation between %NIH area and SE-NIH (r = - 0.083, p = 0.391) or SE-MSA (r = - 0.109, p = 0.259) of SES. However, SE-NIH of PES showed a weak but significant correlation with %NIH area (r = 0.269, p < 0.01). As to the associations between SE-mean and NIH volume index, SES revealed no significant correlation (r = - 0.001, p = 0.990), but PES showed a weak but significant correlation (r = 0.320, p < 0.01). However, there was no difference in the restenosis rate between the eccentric versus concentric groups of both DES. CONCLUSION: This study suggests that lower SE of both SES and PES, which means asymmetric stent expansion, may not be associated with increased NIH.
