Comparison of post-stent irregular protrusion and subsequent neointimal characteristics between second- and third-generation drug-eluting stent implantation
| Autor: | Akiyoshi Shimizu, Reo Anai, Koshi Setoyama, Yutaro Naka, Konosuke Inoue, Yuki Tsuda, Shinjo Sonoda, Masaru Araki, Yoshinori Sanuki, Hiroki Okabe, Toshiya Miura, Yutaka Otsuji |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Neointima
Male medicine.medical_specialty medicine.medical_treatment Lumen (anatomy) 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans In patient 030212 general & internal medicine Homogeneous pattern Aged Retrospective Studies business.industry Stent Drug-Eluting Stents Middle Aged medicine.disease Atherosclerosis Coronary Vessels Third generation Drug-eluting stent Cardiology Female Cardiology and Cardiovascular Medicine business Nuclear medicine Tomography Optical Coherence Calcification |
| Zdroj: | Journal of cardiology. 76(5) |
| ISSN: | 1876-4738 |
| Popis: | Background Third-generation drug-eluting-stents (3rd DES) may improve coronary arterial healing and reduce neoatherosclerosis formation. We evaluated post-stent findings and subsequent vascular healing of 3rd DES by comparing to second-generation drug-eluting-stents (2nd DES) at intermediate-term follow-up using optical coherence tomography (OCT). Method We evaluated 170 patients with 170 lesions who underwent DES implantation (2nd DES, n = 98; 3rd DES, n = 72) and OCT-guided follow-up examination. After propensity score (PS) matching for baseline clinical characteristics, OCT findings from 56 pairs of patients with 2nd DES and 3rd DES implants were compared. Post-stent irregular protrusion (IP) was defined as the protrusion of material with an irregular surface into the lumen between the stent struts. Neoatheroscleosis was defined as neointima contained heterogeneous pattern, rupture, lipid-laden, thin-cap fibroatheroma, or calcification. The presence of peri-strut low-intensity area (PLIA) and in-stent neointimal tissue characteristics were also analyzed at 6- to 8-month follow-up. Results There were no significant differences between the incidence of post-stent IP or neoatherosclerosis formation in the 2nd DES and the 3rd DES (45% vs. 38%, p = 0.44; 30% vs. 20%, p = 0.19, respectively). However, the incidences of PLIA and layered neointimal pattern, which indicate immature neointimal healing, were significantly lower in the 3rd DES compared to the 2nd DES (41% vs. 61%, p = 0.04; 2% vs. 11%, p = 0.04, respectively). As comparing intermediate-term follow-up OCT neointimal findings in patients with IP between 2nd DES and 3rd DES, most neointima tended to have a homogeneous pattern (95% versus 76%, p = 0.06) in the 3rd DES than in the 2nd DES. Conclusions The incidence of post-stent IP and subsequent neoatherosclerosis formation at intermediate-term follow-up after stent implantation were similar between patients with 2nd DES and 3rd DES, however, vascular healing might be favorable when using 3rd DES. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect