Differences in Vessel Healing Between Sirolimus- and Everolimus-Eluting Stent Implantation for Bifurcation Lesions: The J-REVERSE Optical Coherence Tomography Substudy

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• 作者：Daisuke Terashita ; MD^a ; Hiromasa Otake ; MD ; PhD^a ; Toshiro Shinke ; MD ; PhD^a ; ^{shinke@med.kobe-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Yoshinobu Murasato ; MD ; PhD^b ; ^c ; ^d ; Yoshihisa Kinoshita ; MD^e ; Masahiro Yamawaki ; MD ; PhD^f ; Yoshihiro Takeda ; MD ; PhD^g ; Kenichi Fujii ; MD ; PhD^h ; Shin-ichiro Yamada ; MD ; PhDⁱ ; Yoshihisa Shimada ; MD ; PhD^j ; Takehiro Yamashita ; MD ; PhD^k ; Kazuhiko Yumoto ; MD ; PhD^l ; Ken-ichi Hirata ; MD ; PhD^a
• 刊名：Canadian Journal of Cardiology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：32
• 期：3
• 页码：384-390
• 全文大小：565 K

文摘

We aimed to clarify the differences in vessel healing after stenting of bifurcation lesions using sirolimus-eluting stents (SESs) or everolimus-eluting stents (EESs).

Methods

Japanese Registry Study in Comparison Between Everolimus-Eluting Stent and Sirolimus-Eluting Stent for the Bifurcation Lesion (J-REVERSE) is a prospective multicentre registry of 303 bifurcation lesions that were treated with provisional SES or EES with or without final kissing inflation. The first 115 lesions at selected study sites were predefined for inclusion in the optical coherence tomography (OCT) substudy, and 9-month follow-up OCT was conducted in 64 lesions (SES, n = 18; EES, n = 46). In addition to standard OCT parameters, stent eccentricity index (SEI; minimum divided by the maximum stent diameter), neointimal unevenness score (NUS; maximum neointimal thickness in the cross-section [CS] divided by the average neointimal thickness [NIT] of the same CS; uniformity of the neointima suppression) were averaged for each segment (proximal, bifurcation, and distal segments).

Results

Overall, the average stent and luminal area, NIT, and frequency of uncovered struts were similar. The frequency of malapposed struts and SEI were significantly lower in the EES group than in the SES group. The EES group had a significantly smaller NUS in the proximal and distal segments.

Conclusions

EESs offer homogeneous vessel healing with less malapposition in the treatment of bifurcation lesions.