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采用纵向连续光学相干断层成像评估新的无聚合物涂层的依维莫司 A9 涂层冠状动脉支架的愈合特征和新生内膜转化:EGO-BIOFREEDOM 研究。

Establishment of healing profile and neointimal transformation in the new polymer-free biolimus A9-coated coronary stent by longitudinal sequential optical coherence tomography assessments: the EGO-BIOFREEDOM study.

机构信息

Division of Cardiology, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.

出版信息

EuroIntervention. 2018 Sep 20;14(7):780-788. doi: 10.4244/EIJ-D-18-00061.

Abstract

AIMS

This study aimed to establish the early healing and neointimal transformation profile of the new polymer-free BioFreedom stent through sequential optical coherence tomography (OCT) within the first nine months following stent implantation.

METHODS AND RESULTS

We randomly assigned 104 BFS recipients to one of five groups with angiography and OCT follow-up at 1, 2, 3, 4, or 5 months, together with another follow-up for all at nine months. The primary endpoint was the degree of OCT-detected strut coverage at nine months. From 1, 2, 3, 4, and 5 months, median neointimal strut coverage increased from 85.8, 87.0, 88.6, 96.8 to 97.1%, respectively, to 99.6% (IQR 98.2-99.9) at nine months. At nine months, median percent neointimal volume was 13.0% and angiographic late lumen loss was 0.21±0.30 mm. Major adverse cardiac events (MACE) were limited to one non-cardiac death, one non-ST-elevation myocardial infarction not related to BFS, and two target lesion revascularisations without stent thrombosis (MACE rate 4.0%).

CONCLUSIONS

Neointimal strut coverage of the BFS was rapid and the BFS was shown to be clinically safe and effective.

摘要

目的

本研究旨在通过支架置入后第一个 9 个月内连续光学相干断层扫描(OCT),确定新型无聚合物 BioFreedom 支架的早期愈合和新生内膜转化情况。

方法和结果

我们将 104 例 BFS 受植者随机分为五组,分别在 1、2、3、4 或 5 个月时进行血管造影和 OCT 随访,并在 9 个月时对所有患者进行另一次随访。主要终点是 9 个月时 OCT 检测到的支架覆盖率程度。从 1、2、3、4 和 5 个月到 9 个月,中位新生内膜支架覆盖率分别从 85.8%、87.0%、88.6%、96.8%增加到 97.1%(IQR 98.2-99.9)。9 个月时,中位新生内膜体积百分比为 13.0%,血管造影晚期管腔丢失为 0.21±0.30mm。主要不良心脏事件(MACE)仅限于 1 例非心脏性死亡、1 例与 BFS 无关的非 ST 段抬高型心肌梗死和 2 例无支架血栓形成的靶病变血运重建(MACE 发生率为 4.0%)。

结论

BFS 的新生内膜支架覆盖率迅速,BFS 临床安全有效。

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