Katayama Yosuke, Kubo Takashi, Akasaka Takashi, Ino Yasushi, Kimura Kazuo, Okura Hiroyuki, Shinke Toshiro, Igarashi Keiichi, Kadota Kazushige, Kozuma Ken, Tanabe Kengo, Nakagawa Yoshihisa, Muramatsu Toshiya, Morino Yoshihiro, Kimura Takeshi
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
J Cardiol. 2017 Dec;70(6):530-536. doi: 10.1016/j.jjcc.2017.04.005. Epub 2017 May 20.
This study aimed to compare very late vascular response after stent implantation between everolimus-eluting stent (EES) with a thin, non-adhesive, durable, biocompatible fluorinated polymer and biolimus-eluting stent (BES) with a biodegradable polymer by optical coherence tomography (OCT).
In the NOBORI-BES Versus XIENCE V/PROMUS-EES Trial (NEXT), a formal OCT substudy investigated 48 patients (27 EES-treated lesions in 23 patients and 28 BES-treated lesions in 25 patients) with 2-year (18-30 months) follow-up imaging at 18 centers. The percentage of uncovered strut by neointima was significantly lower in EES compared with BES (2.1±4.7% vs. 7.9±10.8%, p=0.013). The percentage of malapposed strut was not different between EES and BES (0.1±0.3% vs. 0.5±1.3%, p=0.138). The frequency of stent with evagination, which is identified as outward bulges in the luminal contour between struts, was significantly lower in EES compared with BES (22% vs. 86%, p<0.001). The frequency of neoatherosclerosis was not different between EES and BES (11% vs. 11%, p=1.000).
At 2 years after stent implantation, uncovered stent strut by neointima and evagination were less frequently observed in EES compared with BES. This OCT study suggests that the very late vascular response is different between EES and BES.
本研究旨在通过光学相干断层扫描（OCT）比较采用薄的、非粘性的、耐用的、生物相容性含氟聚合物的依维莫司洗脱支架（EES）与采用可生物降解聚合物的生物雷帕霉素洗脱支架（BES）植入术后极晚期血管反应。
在NOBORI-BES与XIENCE V/PROMUS-EES试验（NEXT）中，一项正式的OCT子研究在18个中心对48例患者（23例患者中的27个接受EES治疗的病变和25例患者中的28个接受BES治疗的病变）进行了为期2年（18 - 30个月）的随访成像。与BES相比，EES中被新生内膜覆盖的支架小梁百分比显著更低（2.1±4.7%对7.9±10.8%，p = 0.013）。EES和BES之间贴壁不良支架小梁的百分比无差异（0.1±0.3%对0.5±1.3%，p = 0.138）。被定义为支架小梁之间管腔轮廓向外凸起的支架外翻频率，EES显著低于BES（22%对86%，p<0.001）。EES和BES之间新动脉粥样硬化的频率无差异（11%对11%，p = 1.000）。
在支架植入术后2年，与BES相比，EES中较少观察到被新生内膜覆盖的支架小梁和外翻情况。这项OCT研究表明，EES和BES的极晚期血管反应有所不同。
