Early Vascular Healing Following Bioresorbable-Polymer Sirolimus-Eluting Stent Placement Compared to That with Durable-Polymer Everolimus-Eluting Stent

医学 经皮冠状动脉介入治疗 西罗莫司 支架 传统PCI 光学相干层析成像 依维莫司 核医学 内科学 放射科 心脏病学 外科 心肌梗塞
作者
Kunihiro Ogura,Hiroaki Tsujita,Yosuke Oishi,Hidenari Matsumoto,Naoki Matsukawa,Rikuo Sakai,Taito Arai,Shunya Sato,Hideaki Tanaka,Ryota Masaki,Ken Arai,Kosuke Nomura,Ryota Kosaki,Koshiro Sakai,Teruo Sekimoto,Seita Kondo,Shigeto Tsukamoto,Hiroyoshi Mori,Myong Hwa Yamamoto,Kohei Wakabayashi,Hiroshi Suzuki,Masahiko Ochiai,Toshiro Shinke
出处
期刊:International Heart Journal [International Heart Journal Association]
标识
DOI:10.1536/ihj.20-627
摘要

A recent thinner strut drug-eluting stent might facilitate early strut coverage after its placement. We aimed to investigate early vascular healing responses after the placement of an ultrathin-strut bioresorbable-polymer sirolimus-eluting stent (BP-SES) compared to those with a durable-polymer everolimus-eluting stent (DP-EES) using optical coherence tomography (OCT) imaging.This study included 40 patients with chronic coronary syndrome (CCS) who underwent OCT-guided percutaneous coronary intervention (PCI). Twenty patients each received either BP-SES or DP-EES implantation. OCT was performed immediately after stent placement (baseline) and at 1-month follow-up.At one month, the percentage of uncovered struts reduced significantly in both the BP-SES (80.9 ± 10.3% to 2.9 ± 1.7%; P < 0.001) and DP-EES (81.9 ± 13.0% to 5.7 ± 1.8%; P < 0.001) groups, and the percentage was lower in the BP-SES group than in the DP-EES group (P < 0.001). In the BP-SES group, the percentage of malapposed struts also decreased significantly at 1 month (4.9 ± 3.7% to 2.6 ± 3.0%; P = 0.025), which was comparable to that of the DP-EES group (2.5 ± 2.2%; P = 0.860). The optimal cut-off value of the distance between the strut and vessel surface immediately after the placement to predict resolved malapposed struts was ≤ 160 μm for BP-SES and ≤ 190 μm for DP-EES.Compared to DP-EES, ultrathin-strut BP-SES demonstrated favorable vascular responses at one month, with a lower rate of uncovered struts and a comparable rate of malapposed struts.
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