Abstract 15235: Which is Better, Biodegradable-polymer Coated Biolimus A9-eluting Stents or Biocompatible Durable-polymer Coated Everolimus-eluting Stents?: Serial Optical Coherence Tomographic Evaluation
Background: First generation drug-eluting stents (DES) have durable and non-biocompatible polymer, and their polymer can induce chronic inflammation and result in delayed neointimal coverage which may cause very late stent thrombosis (VLST). At present, second generation DESs including biodegradable-polymer coated biolimus A9-eluting stents (BES) whose polymer will be absorbed within twelve months, and biocompatible durable-polymer coated everolimus-eluting stents (EES) are available. However, comparison of BES and EES in terms of neointimal coverage is not fully investigated.
Methods: We performed serial evaluation of neointimal coverage at 8 month (BES polymer still existed) and 20 month follow-up (BES polymer was absorbed) by optical coherence tomography (OCT). Study population consisted of 14 BESs (2243 struts / 250 cross-sections at 8 month, 2061 struts / 260 cross-sections at 20 month follow-up), and 10 EESs (1269 struts / 154 cross-sections at 8 month, 1229 struts / 158 cross-sections at 20 month follow-up). We compared uncovered strut proportion (%Uncovered), malapposed strut proportion (%Malapposed), and average neointimal hyperplasia thickness (Ave-NHT) calculated by OCT between BES and EES, at 8 month and 20 month follow-up, respectively. %Uncovered and %Malapposed were defined as the number of uncovered or malapposed struts divided by observed struts. Ave-NHT was defined as mean value of neointimal hyperplasia thickness on each strut in the same cross-section.
Results: At 8 month, Ave-NHT of EES was significantly higher than that of BES but %Uncovered and %Malapposed were similar between EES and BES. At 20 month, %Uncovered of EES was significantly lower than that of BES, and Ave-NHT of EES was significantly higher than that of BES (a figure).
Conclusions: Biocompatible durable-polymer coated EES showed favorable neointimal healing compared to biodegradable-polymer coated BES, which may be beneficial against VLST.
Author Disclosures: R. Shutta: None. M. Nishino: None. K. Yasumoto: None. K. Yasumura: None. H. Yorifuji: None. K. Masuyama: None. Y. Nushiro: None. T. Kato: None. A. Idemoto: None. A. Tanaka: None. N. Okamoto: None. N. Mori: None. T. Yoshimura: None. N. Makino: None. Y. Egami: None. J. Tanouchi: None.
- © 2014 by American Heart Association, Inc.