在生物吸收过程中评估可吸收性依维莫司洗脱装置的聚合物支杆时的血管内超声（IVUS）射频分析。

IVUS radiofrequency analysis in the evaluation of the polymeric struts of the bioabsorbable everolimus-eluting device during the bioabsorption process.

机构信息

Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.

出版信息

Catheter Cardiovasc Interv. 2010 May 1;75(6):914-8. doi: 10.1002/ccd.22332.

DOI:10.1002/ccd.22332

PMID:20091822

Abstract

BACKGROUND

In the ABSORB study cohort A the changes in the amount of dense calcium and necrotic core have not been reported in comparison to the prestenting phase; this evaluation could be useful to better clarify the bioabsorption process. Aim of this study was therefore to evaluate the dynamic changes in plaque size and plaque tissue composition observed between 6 months and 2 years follow-up, and to compare these findings to the prestenting phase.

METHODS

Angiography, intravascular ultrasound and derived parameters (virtual histology, palpography, and echogenicity) were serially assessed postprocedure, at 6 months and at 2 years in 20 patients. In a subset of 8 patients the same measurements were also recorded in the prestenting phase.

RESULTS

In the total population a reduction of 18% in the plaque area was observed between 6 month and 2 year follow-up (7.56 +/- 2.32 mm2 at 6 months vs. 6.16 +/- 2.10 mm2 at 2 year follow-up; P < 0.01). In the subgroup of eight patients who underwent IVUS during the pre-stenting phase, the plaque area at 2 year follow-up was not significantly different when compared to the prestenting plaque area (7.29 +/- 2.29 mm2 at prestenting vs. 7.48 +/- 1.45 mm2 at 2 year follow-up, P = NS). Necrotic core area was reduced by 24% between the 6 month and 2 year follow-up (0.97 +/- 0.66 mm2 at 6 months vs. 0.74 +/- 0.53 mm2 at 2 year follow-up; P = NS), whilst dense calcium was reduced by 14% from 6 month to 2 year follow-up (0.83 +/- 0.50 mm2 at 6 months vs 0.72 +/- 0.64 mm2 at 2 year follow-up; P = NS). Whilst the necrotic core at 2 years follow-up was not significantly different when compared to the pre-stenting phase (0.62 +/- 0.42 mm2 prestenting vs 1.07 +/- 0.56 mm2 at 2 year follow-up; P = NS), the area of dense calcium was significantly higher at follow-up compared to prestenting (0.35 +/- 0.35 mm2 pre-stenting vs. 0.84 +/- 0.66 mm2 at 2 year follow-up; P < 0.05).

CONCLUSIONS

The reduction in the necrotic core component between 6 month and two year follow-up could be related to a synergistic effect of the bio-absorption process and the anti-inflammatory action of everolimus.

摘要

背景

在 ABSORB 研究队列 A 中，与支架置入前阶段相比，尚未报道致密钙和坏死核心的数量变化；这一评估可能有助于更好地阐明生物吸收过程。因此，本研究的目的是评估在 6 个月至 2 年随访期间斑块大小和斑块组织成分的动态变化，并将这些发现与支架置入前阶段进行比较。

方法

血管造影、血管内超声及衍生参数（虚拟组织学、触诊和回声）在术后、6 个月和 2 年时进行连续评估，20 例患者纳入研究。在 8 例患者的亚组中，在支架置入前阶段也记录了相同的测量值。

结果

在总人群中，在 6 个月至 2 年的随访期间，斑块面积减少了 18%（6 个月时为 7.56±2.32mm2，2 年时为 6.16±2.10mm2；P<0.01）。在 8 例接受支架置入前 IVUS 的患者亚组中，2 年随访时的斑块面积与支架置入前的斑块面积无显著差异（支架置入前为 7.29±2.29mm2，2 年随访时为 7.48±1.45mm2，P=NS）。坏死核心面积在 6 个月至 2 年的随访期间减少了 24%（6 个月时为 0.97±0.66mm2，2 年时为 0.74±0.53mm2；P=NS），而致密钙在 6 个月至 2 年的随访期间减少了 14%（6 个月时为 0.83±0.50mm2，2 年时为 0.72±0.64mm2；P=NS）。尽管 2 年随访时的坏死核心与支架置入前阶段无显著差异（支架置入前为 0.62±0.42mm2，2 年随访时为 1.07±0.56mm2；P=NS），但致密钙的面积在随访时明显高于支架置入前（支架置入前为 0.35±0.35mm2，2 年随访时为 0.84±0.66mm2；P<0.05）。