Abstract 2512: Difference of Heterogeneity of Neointimal Coverage between Sirolimus-Eluting Stent and Paclitaxel-Eluting Stent: An Angioscopic Study
Several angioscopic studies have reported grade of neointimal coverage after drug-eluting stent (DES) implantaion, however, heterogeneous property of neointimal formation after DES implantaion has not been examined yet. In this study, we investigated difference of heterogeneity of neointimal coverage between sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) using coronary angioscope (CAS). Sixty-seven successive patients who received SES or PES implantation underwent 6-month follow-up CAS. We divided our patients into SES and PES group and compared CAS parameters including minimum grade of neointimal coverage, heterogeneity score of neointimal coverage and existence of red mural thrombus and serum parameters including low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, hemoglobin A1c and high sensitive C-reactive protein (hs-CRP) between the two groups. We evaluated the maximum and minimum grade of neointimal coverage within one stent using the following CAS score: 0: no neointimal coverage of stent struts, 1: very thin coverage, 2: struts were embedded but visible and 3: invisible stent struts with full neointimal coverage. Heterogeneity score of neointimal coverage was defined by subtracting minimum grade from maximum grade. Heterogeneity score of neointimal coverage and incidence of red mural thrombi in PES group (n=37) were significantly higher than those in SES group (n=42) while the other parameters including minimum grade of neointimal coverage between the two groups were similar (table⇓). At 6-month follow-up, neointimal coverage of PES is more heterogeneous than that of SES, and this phenomenon may be associated with the presence of angioscopic subclinical thrombi.