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DES 植入后再内皮化与内皮功能的关系:紫杉醇洗脱支架与佐他莫司洗脱支架的比较。

The relationship between re-endothelialization and endothelial function after DES implantation: comparison between paclitaxcel eluting stent and zotarolims eluting stent.

出版信息

Catheter Cardiovasc Interv. 2014 Feb 15;83(3):412-7. doi: 10.1002/ccd.25140.

Abstract

BACKGROUND

Several studies have reported re-endothelialization and endothelial function after drug-eluting stent (DES) implantation; however, the relationship between re-endothelialization and endothelial function after DES implantation has not been investigated yet.

METHODS

A total of 14 patients underwent evaluation of re-endothelialization by optical coherence tomography (OCT) and endothelial function by incremental Ach infusion at 9 months after DES implantation (ZES: N = 7, PES: N = 7). The neointimal thickness (NIT) inside each strut, strut coverage, and malapposition at every 1 mm cross-section were evaluated by OCT and the endothelial function was estimated by measuring the coronary vaso-reactivity in response to acetylcholine (Ach) infusion into coronary arteries.

RESULTS

Zotarolims eluting stent (ZES), compared with paclitaxcel eluting stent (PES), showed more homogeneous neointimal coverage of stent struts and low rate of malapposition. Vasoconstriction in response to Ach in the peri-stent region was also less pronounced in ZES than PES. In particular, vasoconstriction was more often observed in cases with inhomogeneous neointimal coverage of stent struts in the PES group.

CONCLUSIONS

Our findings suggest that endothelial function seems to be better preserved with ZES than PES, and homogeneous neointimal coverage of stent struts seem to be associated with the preserved endothelial function.

摘要

背景

已有多项研究报道药物洗脱支架(DES)置入后的再内皮化和内皮功能;然而,DES 置入后再内皮化与内皮功能之间的关系尚未得到研究。

方法

共 14 例患者在 DES 置入后 9 个月行光学相干断层扫描(OCT)评估再内皮化和乙酰胆碱(Ach)递增输注评估内皮功能(ZES:N=7,PES:N=7)。通过 OCT 评估每个支架内的新生内膜厚度(NIT)、支架覆盖率和贴壁不良情况,并通过测量冠状动脉对乙酰胆碱(Ach)输注的血管反应性来评估内皮功能。

结果

与紫杉醇洗脱支架(PES)相比,佐他莫司洗脱支架(ZES)显示出更均匀的支架支架内新生内膜覆盖和更低的贴壁不良率。在 ZES 中,支架周围区域对 Ach 的血管收缩反应也不如 PES 明显。特别是在 PES 组中,支架支架内新生内膜覆盖不均匀的情况下,更常观察到血管收缩。

结论

我们的研究结果表明,ZES 比 PES 似乎能更好地保留内皮功能,支架支架内新生内膜的均匀覆盖与保留的内皮功能有关。

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