Abstract 14765: The Impact of Post-Procedural Intravascular Ultrasound Measured Minimum Stent Area on Mid-Term Patency After Bare Nitinol Stent and Paclitaxel-Eluting Nitinol Stent Implantation in the Superficial Femoral Artery Lesion
Objectives: Previous intravascular ultrasound (IVUS) studies reported that minimum stent area (MSA) was a strong predictor of in-stent restenosis after bare-metal stent (BMS) and drug-eluting stent (DES) implantation in the coronary artery lesion. We evaluated whether this finding applied in the superficial femoral artery (SFA) lesion after endovascular treatment (EVT).
Methods: We prospectively analyzed 37 consecutive SFA lesions that underwent EVT with self-expanding bare nitinol stent (25 lesions, BMS group) and paclitaxel-eluting nitinol stent (12 lesions, DES group). All patients underwent an IVUS examination at the end of the initial procedure and at 6-month follow-up. Post-procedural MSA and follow-up minimum lumen area (MLA) were obtained for each stent. Percent neointimal area (%NIA) was calculated as neointimal area divided by stent area. Percent stent expanding index was measured as (stent area at follow-up minus post-procedural MSA) divided by post-procedural MSA.
Results: The mean follow-up period was 189±39 days. %Stent expanding index was similar between DES and BMS groups (36.2±14.3% versus 41.9±22.3%, p=NS). Neointimal area and %NIA were significantly smaller in DES group than in BMS group (9.0±4.5mm2 versus 16.6±5.7mm2, p<0.001, and 41.0±20.6% versus 57.2±18.1%, p<0.05, respectively). There was a moderate linear relationship between post-procedural MSA and MLA at follow-up only in DES group (r=0.724, p=0.0096), but not in BMS group (Figure).
Conclusions: Although vascular healing response to BMS differs substantially between individuals, suppression of neointimal proliferation by paclitaxcel did not vary much from individual to individual. Post-procedural MSA can predict mid-term stent patency after paclitaxel-eluting nitinol self-expanding stent implantation in SFA lesions.
- © 2013 by American Heart Association, Inc.