Veteran Affairs North Texas Healthcare System, Dallas, TX, USA.
EuroIntervention. 2011 Dec;7(8):948-54. doi: 10.4244/EIJV7I8A150.
To compare the intravascular ultrasonography (IVUS) findings between saphenous vein grafts (SVG) treated with paclitaxel-eluting stents (PES) vs. bare metal stents (BMS) in the Stenting Of Saphenous Vein Grafts (SOS) trial.
Of the 80 SOS trial patients, 38 had both baseline and follow-up IVUS examination and were included in this substudy: 17 patients received 28 BMS in 26 lesions and 21 patients received 30 PES in 28 lesions. Quantitative IVUS analysis was performed to determine the volume of in-stent neointimal hyperplasia (NIH) - defined as the difference between stent volume and lumen volume in the stented segments. Baseline characteristics were similar between patients who did and did not undergo baseline and follow-up IVUS. Patients receiving BMS and PES had similar stent and lumen volumes immediately after stenting. At 12-month follow-up, compared to BMS, PES-treated lesions had significantly less NIH volume (3.4 vs. 21.9 mm³, p<0.001) and neointima hyperplasia progression (1.6 vs. 17.1 mm³, p<0.001). No significant differences were seen in the 5 mm segment proximal and distal to the stent.
Compared to BMS, use of PES in SVG lesions is associated with significantly lower NIH formation, which may help explain the improved clinical outcomes with PES in these lesions.
比较紫杉醇洗脱支架（PES）与金属裸支架（BMS）治疗的大隐静脉移植物（SVG）的血管内超声（IVUS）结果。
在 Stenting Of Saphenous Vein Grafts（SOS）试验中，80 例 SOS 试验患者中有 38 例同时进行了基线和随访 IVUS 检查，并纳入本亚研究：17 例患者在 26 个病变中接受了 28 个 BMS，21 例患者在 28 个病变中接受了 30 个 PES。定量 IVUS 分析用于确定支架内新生内膜增生（NIH）的体积 - 定义为支架段中支架体积与管腔体积之间的差异。基线特征在接受基线和随访 IVUS 的患者之间相似。接受 BMS 和 PES 的患者在支架置入后即刻具有相似的支架和管腔体积。在 12 个月的随访中，与 BMS 相比，PES 治疗的病变的 NIH 体积明显更小（3.4 与 21.9mm³，p<0.001），新生内膜增生进展更少（1.6 与 17.1mm³，p<0.001）。支架近端和远端 5mm 节段无显著差异。
与 BMS 相比，PES 用于 SVG 病变与 NIH 形成显著降低相关，这可能有助于解释 PES 在这些病变中的临床结局改善。
