Unidad de Cardiología Intervencionista, Cardiología Valdecilla, Hospital Universitario Marques de Valdecilla, Santander, Spain.
EuroIntervention. 2013 Dec;9(8):952-8. doi: 10.4244/EIJV9I8A159.
Optical coherence tomography (OCT) allows a detailed assessment of intimal coverage and strut apposition which are well known substrates for late thrombosis. This study sought to assess and compare long-term coverage and apposition of PES and EES implanted in different lesions of the same coronary artery (and in the same patient).
A total of 30 patients were included. In these patients PES and EES were implanted in the same vessel in two similar lesions. The selection of the stent for each lesion was random. At 12 months, 30 PES were examined analysing 154±90 struts/stents and 30 EES analysing 158±72 struts/stents. The proportion of uncovered struts was 0.8±1.3% for EES and 1.5±2.9% for PES (p=0.3), and the proportion of malapposed struts was 1.25±2.1% and 0.98±2%, respectively (p=0.2). A pooled analysis was performed using the random effects model, given the significant heterogeneity found, which did not show significant differences between EES and PES for non-coverage (RR 0.73, 95% CI: 0.32-1.67) or malapposition (RR 1.60, 95% CI: 0.56-4.61). The presence of non-coverage in malapposed struts was 62% with PES and 15% with EES (p<0.0001), the maximal malapposition area being significantly larger with PES (0.6±0.3 vs. 0.25±0.2 mm², p=0.001).
In highly matched conditions, with PES and EES implanted in the same artery, both DES showed a comparable degree of intimal coverage and apposition at one-year follow-up. A smaller area of malapposition with non-covered struts was found with EES.
光学相干断层扫描（OCT）可对内膜覆盖和支架贴壁情况进行详细评估，这两者是晚期血栓形成的已知底物。本研究旨在评估和比较在同一冠状动脉的不同病变（及同一患者）中植入的 PES 和 EES 的长期覆盖和贴壁情况。
共纳入 30 例患者。这些患者在同一血管的两个类似病变中分别植入 PES 和 EES。每个病变中支架的选择是随机的。12 个月时，对 30 个 PES 进行了检查，共分析了 154±90 个支架/支架；对 30 个 EES 进行了检查，共分析了 158±72 个支架/支架。EES 未覆盖支架的比例为 0.8±1.3%，PES 为 1.5±2.9%（p=0.3）；EES 支架贴壁不良的比例为 1.25±2.1%，PES 为 0.98±2%（p=0.2）。鉴于存在显著异质性，使用随机效应模型进行了汇总分析，结果显示 EES 和 PES 之间在非覆盖（RR 0.73，95%CI：0.32-1.67）或支架贴壁不良（RR 1.60，95%CI：0.56-4.61）方面无显著差异。在支架贴壁不良的支架中，PES 有 62%存在非覆盖，EES 有 15%（p<0.0001），最大贴壁不良面积明显更大，PES 为 0.6±0.3 mm²，EES 为 0.25±0.2 mm²（p=0.001）。
在高度匹配的条件下，在同一动脉中植入 PES 和 EES，两种 DES 在一年随访时显示出可比较的内膜覆盖和贴壁程度。EES 中非覆盖支架的贴壁不良面积更小。
