Division of Cardiology, Department of Internal Medicine, Chunchoen Sacred Heart Hospital, College of Medicine, Hallym University, Chunchoen, Korea.
Int J Cardiovasc Imaging. 2012 Mar;28(3):491-7. doi: 10.1007/s10554-011-9849-7. Epub 2011 Mar 26.
Recent studies reported favorable angiographic and clinical outcomes after everolimus-eluting stent (EES) implantation. However, there were no studies to assess vascular responses after EES implantation using optical coherence tomography (OCT). Therefore, the OCT findings in EES were investigated and compared with those in sirolimus-eluting stent (SES). Follow-up OCT studies were performed in 110 lesions (40 EES and 70 SES) of 104 patients at 9 months after stent implantation. The strut apposition, neointimal hyperplasia (NIH) thickness and stent coverage on each stent struts were evaluated. The mean NIH thickness was significantly greater in EES-treated lesions than in SES-treated lesions (115 ± 52 μm vs. 89 ± 58 μm, P = 0.001, respectively). The percentage of uncovered strut was significantly smaller in EES-treated lesions than in SES-treated lesions (4.4 ± 4.7% vs. 10.5 ± 12.7%, P = 0.016, respectively). There was no significant difference in the percentage of malapposed strut between the two groups (0.4 ± 0.8% in EES vs. 1.7 ± 4.5% in SES, P = 0.344). The incidence of intracoronary thrombus was significantly lower in EES-treated lesions than in SES-treated lesions (5.0% vs. 34.3%, P < 0.001, respectively). EES showed a significantly lower incidence of uncovered stent struts and intracoronary thrombus than SES in 9-month follow-up OCT examination. Compared to SES, EES might have more favorable vascular responses after stent implantation.
近期研究报道，依维莫司洗脱支架（EES）置入后，其血管造影和临床结果均良好。然而，目前尚无研究评估光学相干断层扫描（OCT）在 EES 置入后的血管反应。因此，研究者对 EES 的 OCT 结果进行了研究，并与雷帕霉素洗脱支架（SES）进行了比较。在支架置入后 9 个月时，对 104 例患者的 110 处病变（40 处 EES 和 70 处 SES）进行了随访 OCT 研究。评估了支架各支架梁的贴壁情况、新生内膜增生（NIH）厚度和支架覆盖率。EES 治疗组病变的 NIH 厚度明显大于 SES 治疗组（115±52 μm 比 89±58 μm，P=0.001）。EES 治疗组病变的未覆盖支架梁比例明显小于 SES 治疗组（4.4%±4.7%比 10.5%±12.7%，P=0.016）。两组间未贴壁支架梁的比例无显著差异（EES 组 0.4%±0.8%，SES 组 1.7%±4.5%，P=0.344）。EES 治疗组病变的冠状动脉内血栓发生率明显低于 SES 治疗组（5.0%比 34.3%，P<0.001）。9 个月的 OCT 随访检查中，EES 组的未覆盖支架梁和冠状动脉内血栓发生率明显低于 SES 组。与 SES 相比，EES 可能在支架置入后具有更好的血管反应。
