Division of Cardiology, Osaka Rosai Hospital, Sakai, Osaka, Japan.
JACC Cardiovasc Interv. 2010 Feb;3(2):215-20. doi: 10.1016/j.jcin.2009.10.031.
The purpose of this study is to compare the neointimal formational pattern and incidence of thrombus formation among sirolimus-eluting (SES), paclitaxel-eluting (PES), and bare-metal stents (BMS) with coronary angioscopy.
Neointimal formation and incidence of mural thrombus are different with the type of stent.
One hundred successive patients who received 43 SES, 40 PES, or 32 BMS implantation underwent 6-month follow-up coronary angioscopy. We evaluated angioscopic parameters, including minimum and maximum neointimal grade; presence and number of red mural thrombus; neointimal grade around thrombus; and heterogeneity score, which is defined by subtracting minimum from maximum grade within 1 stent by classifying angioscopic neointimal coverage grades into 4 categories. We compared these parameters among 3 kinds of stent groups.
Heterogeneity scores of SES, PES, and BMS were 0.79 +/- 0.60, 1.27 +/- 0.75, and 1.03 +/- 0.82, respectively (p = 0.011). The PES showed the highest incidence of angioscopic red mural thrombus (50% in PES, 12% in SES, and 3% in BMS, p < 0.001), and the number of thrombus observed within 1 stent in the PES group tended to be larger than those in the SES and BMS groups.
At 6 months after stent implantation, PES showed the most heterogeneous neointimal formation and the highest incidence of thrombus formation compared with SES and BMS.
本研究旨在通过冠状动脉血管镜比较雷帕霉素洗脱支架（SES）、紫杉醇洗脱支架（PES）和裸金属支架（BMS）的新生内膜形成模式和血栓形成发生率。
支架类型不同，新生内膜形成和血栓形成的发生率也不同。
连续 100 例接受 43 个 SES、40 个 PES 或 32 个 BMS 植入的患者接受了 6 个月的冠状动脉血管镜随访。我们评估了血管镜参数，包括最小和最大新生内膜分级；红色壁血栓的存在和数量；血栓周围的新生内膜分级；以及异质性评分，该评分通过将血管镜新生内膜覆盖分级分为 4 类，从 1 个支架内的最小分级减去最大分级来定义。我们比较了这 3 种支架组之间的这些参数。
SES、PES 和 BMS 的异质性评分分别为 0.79 +/- 0.60、1.27 +/- 0.75 和 1.03 +/- 0.82（p = 0.011）。PES 显示出最高的血管镜红色壁血栓形成发生率（50%在 PES，12%在 SES，3%在 BMS，p < 0.001），并且在 PES 组中观察到的血栓数量在 1 个支架内的数量也比 SES 和 BMS 组的数量大。
支架植入后 6 个月，PES 与 SES 和 BMS 相比，新生内膜形成最不均匀，血栓形成发生率最高。
