Abstract 12929: Neointimal Coverage of Everolimus-Eluting Stent Compared to Sirolimus-Eluting Stent: Optical Coherence Tomography Subanalysis from the RESET Trial
Background: Confirming complete neointimal coverage after implantation of a drug-eluting stent is clinically important because incomplete stent coverage is responsible for late thrombosis and sudden cardiac death. Optical coherence tomography (OCT) is emerging as a promising endovascular imaging tool for the evaluation of neointimal response after drug-eluting stent implantation. This study used OCT to compare neointimal response between Everolimus-eluting stents (EESs) and Sirolimus-eluting stents (SESs).
Methods and Results: RESET trial was a prospective dual-arm randomized trial of EESs and SESs in 3197 patients with coronary artery disease. From the RESET trial, 90 patients (EES = 54, SES = 55) with 1-year follow-up OCT were investigated. Image analysis was performed at 1-mm intervals. OCT identified 9591 struts in EESs and 9425 struts in SESs. The frequency of stent struts with neointimal coverage was significantly higher in EESs compared with SESs (89% vs. 83%, p < 0.001). The frequency of malapposed stent struts was significantly lower in EESs compared with SESs (0.01% vs. 1%, p < 0.001). Averaged neointimal thickness (128 ± 53 μ m vs. 124 ± 73 μ m, p = 0.751) and neointimal volume (25.71 ± 14.11mm3 vs. 23.90 ± 17.56mm3, p = 0.555) was similar in EESs and SESs. Thrombus was observed in 2% of EESs and 11% of SESs (p = 0.113).
Conclusions: In this OCT subanalysis from RESET trial, neointimal coverage was incomplete in both EESs and SESs at 1-year after stent implantation. Uncovered struts and malapposed struts were less observed in EESs compared with SESs.
- Intravascular ultrasound/Doppler
- Interventional cardiology
- Drug eluting stents
- Coronary artery disease
- © 2012 by American Heart Association, Inc.