Abstract 12201: Serial Optical Coherence Tomographic Evaluation of Neointimal Response in Overlapping Segments between Everolimus- Eluting stents and Sirolimus- Eluting Stents
Background: Although overlapping coronary stents are common, recent clinical studies have revealed an adverse neointimal response in overlapping drug eluting stents due to increased drug and polymer toxicity. Thus, we evaluate serial changes of neointimal response in overlapping segments between everolimus- eluting stents (EES) and sirolimus-eluting stents (SES) by optical coherence tomography (OCT).
Methods: Nineteen consecutive lesions treated with overlapping stents (12 EES and 7 SES) were analyzed by OCT at 6-8 months and 18-20 months after stent implantation. We performed the detailed serial evaluations of OCT parameters including the uncovered or malapposed struts ratio (%), neointimal hyperplasia area% (NIH%, neointimal hyperplasia area / stent area) and strut-level NIH thickness between overlapping segments of EES and those of SES. Heterogeneity index (sum of (max NIH thickness - minimum one) at each cross-section / number of cross-sections) at 18-20 months was also calculated.
Results: A total of 3289 struts (EES=1014 SES=636 at 6-8 months, EES=1018 SES=621at 18-20 months) in 290 cross-sections (EES=82 SES=63 at 6-8 months, EES=82 SES=63 at 18-20 months) of 19 stented segments were analyzed. Serial changes were shown in a figure. Heterogeneity index in EES was significantly lower than in SES (99±46 vs. 195±105, p<0.01)
Conclusions: Neointimal coverage in EES was more homogenous than in SES, while EES and SES showed similarly serial changes of neointimal response in overlapping segments.
- © 2012 by American Heart Association, Inc.