La Manna Alessio, Capodanno Davide, Cera Maria, Di Salvo Maria Elena, Sacchetta Giorgio, Corcos Thierry, Prati Francesco, Tamburino Corrado
Cardiology Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
Am J Cardiol. 2009 Jun 1;103(11):1551-5. doi: 10.1016/j.amjcard.2009.01.378. Epub 2009 Apr 8.
Drug-eluting stents were devised as an answer to restenosis, but research has shown that the eluting drug can interfere with the blood vessel's healing process, thus increasing the risk of stent thrombosis. A stent coated with the new proprietary polymer Polyzene-F, is a novel technical solution that promises to decrease in-stent restenosis and tackle the risk of thrombosis. Fifty-five patients were enrolled in the first clinical human study (ATLANTA registry), addressing the short-term follow-up results of the CATANIA stent with Polyzene-F. As a part of the study protocol, 15 patients were randomly assigned to optical coherence tomographic (OCT) examination at 6-month follow-up. Optical coherence tomograms were obtained using a Lightlab M2 system with a motorized pull-back at 2.0 mm/s. OCT images were acquired at 15.6 frames/s. A total of 1,904 cross-sectional images with 19,028 struts were analyzed. The rate of covered struts was 99.5%, whereas malapposed struts accounted for 0.15%. Area measurements were performed in 476 cross sections. Neointimal hyperplasia (NIH) area and percent NIH area were 3.2 +/- 1.4 mm2 and 38 +/- 17%, respectively. Percent NIH area was comparable between diabetics and nondiabetics. Qualitative assessment of OCT images demonstrated neither occurrence of stent fractures nor thrombus. In conclusion, OCT assessment of the Polyzene-F-covered stent at follow-up showed a small percentage of neointima. Also, almost complete stent strut coverage was revealed by optical coherence tomography. These figures indicate that the CATANIA stent with Polyzene-F is a promising solution for decreasing late stent restenosis and preventing thrombosis.
药物洗脱支架是为解决再狭窄问题而设计的,但研究表明,洗脱药物会干扰血管的愈合过程,从而增加支架血栓形成的风险。一种涂有新型专利聚合物Polyzene-F的支架是一种新颖的技术解决方案,有望减少支架内再狭窄并应对血栓形成风险。55名患者参与了第一项临床人体研究(亚特兰大注册研究),该研究针对的是带有Polyzene-F的卡塔尼亚支架的短期随访结果。作为研究方案的一部分,15名患者在6个月随访时被随机分配接受光学相干断层扫描(OCT)检查。使用Lightlab M2系统以2.0毫米/秒的自动回撤速度获取光学相干断层扫描图像。OCT图像以15.6帧/秒的速度采集。共分析了1904张横截面图像和19028个支架小梁。覆盖的支架小梁比例为99.5%,而贴壁不良的支架小梁占0.15%。在476个横截面中进行了面积测量。新生内膜增生(NIH)面积和NIH面积百分比分别为3.2±1.4平方毫米和38±17%。糖尿病患者和非糖尿病患者的NIH面积百分比相当。OCT图像的定性评估未发现支架断裂或血栓形成。总之,随访时对涂有Polyzene-F的支架进行OCT评估显示新生内膜比例较小。此外,光学相干断层扫描显示几乎完全覆盖了支架小梁。这些数据表明,带有Polyzene-F的卡塔尼亚支架是减少晚期支架内再狭窄和预防血栓形成的一种有前景的解决方案。