Evaluation of the peri-strut low intensity area following sirolimus- and paclitaxel-eluting stents implantation: Insights from an optical coherence tomography study in humans

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• 作者：Hiromasa Otake^a ; ^b ; Junya Shite^a ; ^{shite@med.kobe-u.ac.jp} ; Fumiaki Ikeno^b ; Toshiro Shinke^a ; Tomohiko Teramoto^b ; Naoki Miyoshi^a ; Junya Ako^b ; Yasuhiro Honda^b ; Peter J. Fitzgerald^b ; Ken-ichi Hirata^a
• 关键词：IVUS ; intravascular ultrasound ; DES ; drug-eluting stents ; OCT ; optical coherence tomography ; PLIA ; peri-strut low intensity area ; SES ; sirolimus-eluting stents ; PES ; paclitaxel-eluting stents ; NIT ; neointimal thickness ; +  ; PLIA stents ; stents with PLI
• 刊名：International Journal of Cardiology
• 出版年：2012
• 期刊代码：128_01675273
• 类别：med
• 出版时间：17 May, 2012
• 卷：157
• 期：1
• 页码：38-42
• 文件大小：514 K

摘要

Background

Recent pathological studies have demonstrated that peri-strut low intensity area (PLIA) seen on optical coherence tomography (OCT) imaging represents the presence of fibrinogen and/or extracellular matrix. We sought to assess the clinical prevalence of PLIA and its relation to neointimal proliferation after the implantation of sirolimus- (SES) and paclitaxel-eluting stents (PES) in humans.

Methods

Seventy patients underwent 6-months follow-up OCT after SES (43 stents) or PES (37 stents) implantation. PLIA was defined as a region around stent struts with homogenous lower intensity than surrounding tissue on OCT images without signal attenuation. The incidence of stent struts with PLIA (+ PLIA struts) was calculated as the number of + PLIA struts/number of all struts (%).

Results

PES showed a higher incidence of stents with PLIA than SES (86%vs. 58%; p = 0.005) with a higher prevalence of + PLIA struts (27.8 卤 21.9%vs. 10.9 卤 11.0%; p = 0.0008). SES with PLIA showed a significantly greater neointimal thickness (NIT) than SES without PLIA (p = 0.02), while PES showed a similar tendency (p = 0.19). In a detailed strut basis analysis, average NIT on + PLIA struts were significantly greater than that on 鈭扨LIA struts in both SES and PES. In addition, average NIT was positively correlated with the prevalence of + PLIA struts (SES: Rho = 0.73; p < 0.0001, PES: Rho = 0.58, p = 0.0005) in both stents.

Conclusions

The prevalence of PLIA was significantly higher in PES than in SES. The presence and extent of PLIA might be associated with intimal thickening after 1st-generation DES implantation.