TY - JOUR
T1 - Long-Term Vascular Healing in Response to Sirolimus- and Paclitaxel-Eluting Stents An Optical Coherence Tomography Study
AU - Raber, L
AU - Baumgartner, S
AU - Garcia Garcia, Hector
AU - Kalesan, B
AU - Justiz, J
AU - Pilgrim, T
AU - Moschovitis, A
AU - Khattab, AA
AU - Buellesfeld, L
AU - Wenaweser, P
AU - Meier, B
AU - Serruys, PWJC (Patrick)
AU - Juni, P
AU - Windecker, S
PY - 2012
Y1 - 2012
N2 - Objectives This study sought to assess stent strut coverage, malapposition, protrusion, and coronary evaginations as markers of healing 5 years after implantation of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES), by optical coherence tomography (OCT). Background Early-generation drug-eluting stents have been shown to delay vascular healing. Methods A total of 88 event-free patients with 1 randomly selected lesion were suitable for final OCT analysis 5 years after drug-eluting stent implantation. The analytical approach was based on a hierarchical Bayesian random-effects model. Results OCT analysis was performed at 5 years in 41 SES lesions with 6,380 struts, and in 47 PES lesions with 6,782 struts. A total of 196 struts were uncovered in SES (1.5%) compared with 185 struts in PES lesions (1.0%, 95% credibility interval [CrI]: 0.5 to 1.6; p = 0.32). Malapposed struts were present in 1.2% of SES compared with 0.7% of PES struts (0.7%, 95% CrI: 0.03 to 1.6; p = 0.23). Protruding struts were more frequent among SES (n = 114; 0.8%) than PES lesions (n = 24; 0.1%, 95% CrI: Conclusions Early-generation drug-eluting stents show a similar degree of strut coverage and malapposition at 5 years of follow-up. Despite an overall low degree of uncovered and malapposed struts in event-free patients, some lesions show a clustering of these characteristics, indicating a heterogeneous healing response, which may be the source for very late adverse events. (J Am Coll Cardiol Intv 2012;5:946-57) (C) 2012 by the American College of Cardiology Foundation
AB - Objectives This study sought to assess stent strut coverage, malapposition, protrusion, and coronary evaginations as markers of healing 5 years after implantation of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES), by optical coherence tomography (OCT). Background Early-generation drug-eluting stents have been shown to delay vascular healing. Methods A total of 88 event-free patients with 1 randomly selected lesion were suitable for final OCT analysis 5 years after drug-eluting stent implantation. The analytical approach was based on a hierarchical Bayesian random-effects model. Results OCT analysis was performed at 5 years in 41 SES lesions with 6,380 struts, and in 47 PES lesions with 6,782 struts. A total of 196 struts were uncovered in SES (1.5%) compared with 185 struts in PES lesions (1.0%, 95% credibility interval [CrI]: 0.5 to 1.6; p = 0.32). Malapposed struts were present in 1.2% of SES compared with 0.7% of PES struts (0.7%, 95% CrI: 0.03 to 1.6; p = 0.23). Protruding struts were more frequent among SES (n = 114; 0.8%) than PES lesions (n = 24; 0.1%, 95% CrI: Conclusions Early-generation drug-eluting stents show a similar degree of strut coverage and malapposition at 5 years of follow-up. Despite an overall low degree of uncovered and malapposed struts in event-free patients, some lesions show a clustering of these characteristics, indicating a heterogeneous healing response, which may be the source for very late adverse events. (J Am Coll Cardiol Intv 2012;5:946-57) (C) 2012 by the American College of Cardiology Foundation
U2 - 10.1016/j.jcin.2012.05.012
DO - 10.1016/j.jcin.2012.05.012
M3 - Article
C2 - 22995882
SN - 1936-8798
VL - 5
SP - 946
EP - 957
JO - JACC-Cardiovascular interventions
JF - JACC-Cardiovascular interventions
IS - 9
ER -