Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Circ J. 2010 May;74(5):903-8. doi: 10.1253/circj.cj-09-0690. Epub 2010 Mar 10.
Differences between paclitaxel-eluting stents (PES) and sirolimus-eluting stent (SES) in neointimal proliferation under strictly matched conditions remain to be clarified by optical coherence tomography (OCT).
Between May and December 2007, 27 patients were implanted with a PES and a SES, randomized to either the proximal or distal site in a single coronary artery, and underwent follow-up angiography and OCT examination at 6 months. The frequency of vessel wall apposition with neointima was greater for PES than for SES (92.6% vs 85.8%, P<0.01). The median (25th, 75th percentiles) neointimal thickness (NIT) in PES was significantly greater than that in SES (90 microm [25th: 40 microm; 75th: 200 microm] vs 50 microm [25th: 20 microm; 75th: 140 microm]; P<0.01). Both the average difference between the maximum and minimum NIT in each cross-section and the average difference between the maximum and minimum NIT in the longitudinal axis were larger in PES than in SES (206+/-88 vs 131+/-57 microm; P<0.001, 607+/-243 vs 400+/-185 microm; P<0.001). Low-density spots were significantly more frequently observed in PES than in SES (30.9% vs 17.0%, P=0.001).
Compared with SES, PES had a non-uniform and larger neointimal thickness with fewer uncovered struts, and more peri-strut low-density areas.
光学相干断层扫描（OCT）显示，在严格匹配的条件下，紫杉醇洗脱支架（PES）和西罗莫司洗脱支架（SES）的新生内膜增殖存在差异。
2007 年 5 月至 12 月，27 例患者分别植入 PES 和 SES，随机在单支冠状动脉的近端或远端，在 6 个月时进行随访血管造影和 OCT 检查。PES 支架壁贴壁与新生内膜的频率高于 SES（92.6%比 85.8%，P<0.01）。PES 的中位（25%、75%分位数）新生内膜厚度（NIT）明显大于 SES（90μm[25%：40μm；75%：200μm]比 50μm[25%：20μm；75%：140μm]；P<0.01）。PES 各节段最大和最小 NIT 之间的平均差值以及最大和最小 NIT 在纵轴上的平均差值均大于 SES（206+/-88 比 131+/-57μm；P<0.001，607+/-243 比 400+/-185μm；P<0.001）。PES 中低密度斑块的发生率明显高于 SES（30.9%比 17.0%，P=0.001）。
与 SES 相比，PES 具有非均匀性和更大的新生内膜厚度，覆盖支架更少，支架周围低密度区更多。
