Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
EuroIntervention. 2015 Sep;11(5):564-71. doi: 10.4244/EIJV11I5A109.
The aim of the present study was to compare vascular healing response between the first-generation sirolimus-eluting stent (SES) and the second-generation everolimus-eluting stent (EES) by using optical coherence tomography (OCT).
The RESET was a prospective, multicentre, randomised, open-label trial comparing EES and SES. Of the 3,197 patients enrolled in the RESET, nine-month follow-up OCT after stent implantation was performed in 100 patients (48 EES-treated lesions in 44 patients and 62 SES-treated lesions in 56 patients), thus constituting the OCT substudy population. The percentage of uncovered struts per lesion (8±15% vs. 14±19%, p=0.031) and cross-sections with >30% uncovered struts per lesion (6±14% vs. 18±29%, p=0.009) was significantly lower in EES compared with SES. The frequency of DES-treated lesions with incomplete stent apposition (8 [17%] vs. 29 [47%], p<0.001) was significantly lower in EES compared with SES. Intra-stent thrombus was comparably observed between EES and SES (1 [2%] vs. 5 [8%], p=0.229).
Compared with SES, EES was associated with a favourable vascular response at nine months after stent implantation.
本研究旨在通过光学相干断层扫描(OCT)比较第一代西罗莫司洗脱支架(SES)和第二代依维莫司洗脱支架(EES)的血管愈合反应。
RESET 是一项前瞻性、多中心、随机、开放标签试验,比较 EES 和 SES。在 RESET 纳入的 3197 例患者中,100 例患者(44 例患者的 48 个 EES 治疗病变和 56 例患者的 62 个 SES 治疗病变)在支架植入后 9 个月进行了 OCT 随访,因此构成了 OCT 亚组研究人群。EES 组每个病变未覆盖支架梁的比例(8±15% vs. 14±19%,p=0.031)和每个病变有>30%未覆盖支架梁的节段比例(6±14% vs. 18±29%,p=0.009)显著低于 SES 组。EES 组与 SES 组相比,DES 治疗病变中不完全支架贴壁的发生率(8[17%] vs. 29[47%],p<0.001)显著降低。EES 组与 SES 组的支架内血栓形成发生率相似(1[2%] vs. 5[8%],p=0.229)。
与 SES 相比,EES 与支架植入后 9 个月时的有利血管反应相关。