Abstract 20701: Favorable and Unfavorable Vascular Responses Early After Second-Generation Drug Eluting Stent Implantation: An Optical Coherence Tomographic Study
Introduction: Early phase vascular response to various types of second-generation drug eluting stents(DES) is not well known.
Hypothesis: Early phase vascular response to second-generation stent vary by stent types. This study aimed to compare the early phase vascular response of the stented vessels with 3 different types of second-generation DESs.
Methods: We analyzed optical coherence tomographic(OCT) imaging from 43 patients both immediately after and early (mean 29 days) after second-generation DES implantation. There were 22 patients with cobalt-chromium everolimus-eluting stent (CoCr-EES: Xience), 13 with platinum-chromium everolimus-eluting stent (PtCr-EES: Promus), and 8 with Resolute zotarolimus-eluting stent (Re-ZES). OCT images were analyzed at 1-mm intervals, and 8,389 struts were analyzed.
Results: Numbers of malapposed struts immediately after stent implantation did not differ among the 3 DES groups. At early phase, rate of tissue coverage of stent struts was very high (92-100%) in all kinds of DES. However, rate of malapposition resolution at early follow-up were significantly different among the groups (CoCr-EES 52%, PtCr-EES 78%, Re-ZES 22%, p=0.039). Moreover, unfavorable healing processes such as early-acquired malapposition and early-developed multiple inter-strut hollow(MIH) also indicated significant difference among the groups (incidence/100 stent struts: CoCr-EES 1.4+/-2.5, PtCr-EES 1.1+/-1.5, Re-ZES 6.1+/-9.2, p=0.024).
Conclusions: Stent coverage rate at the early phase was very high in all 3 DESs, however, delayed resolution of malapposition, and unfavorable processes like acquired malapposition and early-developed MIH were significantly frequent in Re-ZES.
Author Disclosures: Y. Oishi: None. S. Watanabe: None. M. Toyama: None. E. Ojima: None. Y. Muta: None. S. Maruta: None. Y. Kuroda: None.
- © 2016 by American Heart Association, Inc.