Fujiwara Takayuki, Sakakura Kenichi, Ako Junya, Wada Hiroshi, Arao Kenshiro, Sugawara Yoshitaka, Momomura Shin-ichi
Department of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Int Heart J. 2012;53(3):165-9. doi: 10.1536/ihj.53.165.
Peri-stent contrast staining (PSS) is an abnormal angiographic finding following drug-eluting stent implantation which suggests the presence of a space outside the stent struts. PSS has been reported to be associated with very late stent thrombosis (VLST). The aims of this study were to compare the occurrence rate of late acquired PSS between sirolimus-eluting stent (SES) and everolimus-eluting stent (EES) implantation, and to identify clinical characteristics associated with PSS. The percutaneous coronary intervention (PCI) database of our hospital was queried to identify patients meeting the following criteria: (i) patients who received SES or EES in de novo coronary artery lesions; and (ii) patients who had angiographic follow-up between 3 and 15 months after stent implantation. There were 221 patients with 249 lesions treated with SES, and 173 patients with 212 lesions treated with EES. The occurrence of PSS was evaluated and compared between SES and EES implantation on a patient and lesion basis. The occurrence rate of late acquired PSS with EES was lower than that with SES. (On a patient basis; 1.2% versus 4.5%, P = 0.045, on a lesion basis; 0.9% versus 4.0%, P = 0.043). Among the clinical characteristics, chronic total occlusion (CTO) lesions were associated with PSS. The occurrence of late acquired PSS in EES was lower than that in SES. In conclusion, the occurrence rate of late acquired PSS with EES was lower than that with SES, however, it remains to be determined whether this difference translates to the difference in the rate of VLST.
支架周围造影剂染色（PSS）是药物洗脱支架植入后一种异常的血管造影表现，提示支架小梁外存在间隙。据报道，PSS与极晚期支架血栓形成（VLST）有关。本研究的目的是比较西罗莫司洗脱支架（SES）和依维莫司洗脱支架（EES）植入后迟发性获得性PSS的发生率，并确定与PSS相关的临床特征。查询了我院的经皮冠状动脉介入治疗（PCI）数据库，以确定符合以下标准的患者：（i）在原发性冠状动脉病变中接受SES或EES的患者；（ii）在支架植入后3至15个月进行血管造影随访的患者。SES治疗221例患者249处病变，EES治疗173例患者212处病变。在患者和病变基础上评估并比较SES和EES植入后PSS的发生情况。EES迟发性获得性PSS的发生率低于SES。（在患者基础上；1.2%对4.5%，P = 0.045，在病变基础上；0.9%对4.0%，P = 0.043）。在临床特征中，慢性完全闭塞（CTO）病变与PSS有关。EES迟发性获得性PSS的发生率低于SES。总之，EES迟发性获得性PSS的发生率低于SES，然而，这种差异是否转化为VLST发生率的差异仍有待确定。
