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西罗莫司洗脱支架对新生内膜增殖的持续抑制作用:一年血管造影和血管内超声随访

Sustained suppression of neointimal proliferation by sirolimus-eluting stents: one-year angiographic and intravascular ultrasound follow-up.

作者信息

Sousa J E, Costa M A, Abizaid A C, Rensing B J, Abizaid A S, Tanajura L F, Kozuma K, Van Langenhove G, Sousa A G, Falotico R, Jaeger J, Popma J J, Serruys P W

机构信息

Institute Dante Pazzanese of Cardiology, São Paulo, Brazil.

出版信息

Circulation. 2001 Oct 23;104(17):2007-11. doi: 10.1161/hc4201.098056.

Abstract

BACKGROUND

We have previously reported a virtual absence of neointimal hyperplasia 4 months after implantation of sirolimus-eluting stents. The aim of the present investigation was to determine whether these results are sustained over a period of 1 year.

METHODS AND RESULTS

Forty-five patients with de novo coronary disease were successfully treated with the implantation of a single sirolimus-eluting Bx VELOCITY stent in São Paulo, Brazil (n=30, 15 fast release [group I, GI] and 15 slow release [GII]) and Rotterdam, The Netherlands (15 slow release, GIII). Angiographic and volumetric intravascular ultrasound (IVUS) follow-up was obtained at 4 and 12 months (GI and GII) and 6 months (GIII). In-stent minimal lumen diameter and percent diameter stenosis remained essentially unchanged in all groups (at 12 months, GI and GII; at 6 months, GIII). Follow-up in-lesion minimal lumen diameter was 2.28 mm (GIII), 2.32 mm (GI), and 2.48 mm (GII). No patient approached the >/=50% diameter stenosis at 1 year by angiography or IVUS assessment, and no edge restenosis was observed. Neointimal hyperplasia, as detected by IVUS, was virtually absent at 6 months (2+/-5% obstruction volume, GIII) and at 12 months (GI=2+/-5% and GII=2+/-3%).

CONCLUSIONS

This study demonstrates a sustained suppression of neointimal proliferation by sirolimus-eluting Bx VELOCITY stents 1 year after implantation.

摘要

背景

我们之前报道过西罗莫司洗脱支架植入4个月后几乎没有新生内膜增生。本研究的目的是确定这些结果在1年的时间内是否持续存在。

方法与结果

45例初发冠心病患者在巴西圣保罗(n = 30,15例快速释放[I组,GI]和15例缓慢释放[II组,GII])以及荷兰鹿特丹(15例缓慢释放,III组,GIII)成功植入单个西罗莫司洗脱Bx VELOCITY支架。在4个月和12个月(GI和GII)以及6个月(GIII)时进行血管造影和血管内超声(IVUS)容积随访。所有组的支架内最小管腔直径和直径狭窄百分比基本保持不变(12个月时,GI和GII;6个月时,GIII)。随访时病变内最小管腔直径为2.28 mm(GIII)、2.32 mm(GI)和2.48 mm(GII)。通过血管造影或IVUS评估,1年内没有患者的直径狭窄接近或超过50%,也未观察到边缘再狭窄。IVUS检测到的新生内膜增生在6个月时几乎不存在(阻塞体积2±5%,GIII),在12个月时(GI = 2±5%,GII = 2±3%)也是如此。

结论

本研究表明,西罗莫司洗脱Bx VELOCITY支架植入1年后对新生内膜增殖有持续抑制作用。

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