紫杉醇洗脱支架置入 18 个月后血栓形成发生率高：与西罗莫司洗脱支架的血管镜比较。

High incidence of thrombus formation at 18 months after paclitaxel-eluting stent implantation: angioscopic comparison with sirolimus-eluting stent.

机构信息

Osaka Rosai Hospital, Sakai, Japan.

出版信息

Am Heart J. 2010 May;159(5):905-10. doi: 10.1016/j.ahj.2010.02.032.

DOI:10.1016/j.ahj.2010.02.032

PMID:20435203

Abstract

BACKGROUND

Difference of neointimal formational pattern and incidence of thrombus formation between sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) at 18 months after stent implantation has not previously been reported.

METHODS

We retrospectively enrolled 35 event-free patients who received SES (15 patients, 18 stents) or PES (20 patients, 23 stents) implantation with 18-month follow-up coronary angioscopy. We divided our patients into SES or PES groups and compared neointimal coverage pattern and incidence of red mural thrombus formation between the 2 groups. Neointimal coverage grades were classified into 4 categories. Minimum neointimal coverage grade, maximum grade, and heterogeneity score were assessed in each stent. Heterogeneity score was calculated by subtracting minimum from maximum grade within one stent.

RESULTS

Minimum neointimal coverage grade of PES was significantly lower than that of SES (0.70 +/- 0.64 vs 1.33 +/- 0.69, P = .005), whereas maximum grade was not significantly different (2.48 +/- 0.73 vs 2.22 +/- 0.73, P = .218). Heterogeneity score and incidence of red mural thrombus of PES were higher than those of SES (1.78 +/- 0.80 vs 0.89 +/- 0.76, P = .002 and 70% vs 11%, P < .001).

CONCLUSIONS

The present study revealed that PES shows more heterogeneous neointimal coverage and higher incidence of thrombus formation as compared with SES at 18 months after stent implantation.

摘要

背景

支架置入 18 个月后，雷帕霉素洗脱支架（SES）和紫杉醇洗脱支架（PES）之间的新生内膜形成模式和血栓形成发生率的差异尚未见报道。

方法

我们回顾性纳入了 35 例无事件生存患者，这些患者分别接受了 SES（15 例，18 个支架）或 PES（20 例，23 个支架）植入，并进行了 18 个月的冠状动脉血管镜随访。我们将患者分为 SES 或 PES 组，并比较了两组之间的新生内膜覆盖模式和红色壁血栓形成的发生率。将新生内膜覆盖等级分为 4 类。评估每个支架的最小新生内膜覆盖等级、最大等级和异质性评分。异质性评分通过从一个支架内的最小等级减去最大等级来计算。

结果

PES 的最小新生内膜覆盖等级明显低于 SES（0.70±0.64 比 1.33±0.69，P=0.005），而最大等级无明显差异（2.48±0.73 比 2.22±0.73，P=0.218）。PES 的异质性评分和红色壁血栓的发生率高于 SES（1.78±0.80 比 0.89±0.76，P=0.002 和 70%比 11%，P＜0.001）。