Abstract 19076: Long-Term Vascular Response to Cobalt-Chromium Everolimus-Eluting Stent: Five-Year Follow-Up Optical Coherence Tomography Study
Introduction: The cobalt-chromium everolimus-eluting stent (CoCr-EES) have shown the improved safety and efficacy compared with first-generation drug-eluting stents. However, the long-term vascular response to CoCr-EES has not been fully evaluated.
Hypothesis: We sought to assess the vascular response to CoCr-EES at 5 years after stent implantation using optical coherence tomography (OCT).
Methods: From April 2015 and January 2016, a total of 24 patient (28 lesions) treated only with CoCr-EES and without any treated-vessel related events during the 5 years after the procedure were prospectively enrolled at 2 Japanese institutions. Quantitative parameters and qualitative characteristics of the neointima were evaluated. In addition, to assess whether the lesion complexity affects the long-term vascular response to CoCr-EES, we compared the OCT findings between lesions with type C of the AHA/ACC classification and those with non-type C.
Results: A total of 5738 struts in 35 CoCr-EESs were analyzed. Uncovered and malapposed struts were found in 62 (1.1%) and 38 (0.66%) out of 5738 struts, respectively. Cross-sectional qualitative analysis of the neointima tissue showed that the frequency of lipid-laden neointima was 24 out of 621 cross-sections (3.9%). Compared with non-type C lesions, the frequency of malapposed struts was significantly higher in type C lesions (0.92% vs. 0.19%, p <0.001), whereas that of uncovered struts was similar between the 2 groups (1.1% and 1.1%, p >0.99). No significant difference in the frequency of lipid-laden neointima was found between the type C and non-type C lesions (2.8% vs. 5.7%, p=0.09)
Conclusions: CoCr-EES shows an excellent vascular response at 5-year follow-up. The lesion complexity might have little influence on long-term vascular response to CoCr-EES in stable patients.
Author Disclosures: S. Kuramitsu: None. S. Sonoda: None. H. Jinnouchi: None. Y. Muraoka: None. S. Shirai: None. K. Ando: None.
- © 2016 by American Heart Association, Inc.