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第二代佐他莫司洗脱耐用聚合物支架的短期支架覆盖情况:奥尼克斯一个月光学相干断层扫描研究

Short-term stent coverage of second-generation zotarolimus-eluting durable polymer stents: Onyx one-month optical coherence tomography study.

作者信息

Roleder Tomasz, Kedhi Elvin, Berta Balazs, Gasior Pawel, Wanha Wojciech, Roleder Magda, Fluder Joanna, Smolka Grzegorz, Ochala Andrzej, Wojakowski Wojciech

机构信息

Department of Cardiology and Structural Heart Diseases, 3 Division of Cardiology, Medical University of Silesia, Katowice, Poland.

Isala Haartcentrum, Zwolle, Netherlands.

出版信息

Postepy Kardiol Interwencyjnej. 2019;15(2):143-150. doi: 10.5114/aic.2019.86009. Epub 2019 Jun 26.

Abstract

INTRODUCTION

To date the early strut coverage with the second-generation durable-polymer ONYX zotarolimus-eluting stent (O-ZES) is unknown.

AIM

Optical coherence tomography (OCT) assessed the strut coverage of O-ZES at thirty-day follow-up.

MATERIAL AND METHODS

OCT was performed after implantation and at 1-month follow-up in 15 patients treated with O-ZES.

RESULTS

Mean patient age was 67 ±7 years (73% males). The clinical presentation consisted of acute coronary syndromes ( = 13) and stable coronary disease ( = 2). Four (26%) patients had diabetes. OCT analysis was performed at baseline and 1-month follow-up in all stents. 378 cross-sections with 3582 struts were assessed at baseline and 3661 at follow-up. At follow-up, 88% struts were covered by tissue with a median thickness 37.91 μm (IQR: 22.32-64.15). Median in-stent area obstruction by neointima was 2.64% (IQR: 1.70-4.84). From the total stent covered area, 92.3% showed complete strut coverage. Homogeneous tissue was observed in 74% of cases. There were no differences in minimal lumen area (5.07 ±1.08 mm vs. 4.81 ±0.94 mm, = 0.125) or minimal stent area (4.95 ±1.22 mm vs. 4.92 ±0.99 mm) at baseline and at follow-up. There were no differences in the rate of strut malapposition (4.3% vs. 5.7%, = 0.417). For all stents, malapposition volume was 47.9 mm at baseline and 51.7 mm at follow-up, giving the late acquired stent malapposition volume of 3.8 mm.

CONCLUSIONS

The second-generation durable polymer O-ZES showed favorable vessel healing at 30-day OCT follow-up.

摘要

引言

迄今为止,第二代耐用聚合物佐他莫司洗脱支架(O-ZES)早期的支架小梁覆盖情况尚不清楚。

目的

光学相干断层扫描(OCT)评估O-ZES在30天随访时的支架小梁覆盖情况。

材料与方法

对15例接受O-ZES治疗的患者在植入后及1个月随访时进行OCT检查。

结果

患者平均年龄为67±7岁(73%为男性)。临床表现包括急性冠状动脉综合征(n = 13)和稳定型冠心病(n = 2)。4例(26%)患者患有糖尿病。对所有支架在基线和1个月随访时进行OCT分析。基线时评估了378个包含3582个支架小梁的横截面,随访时评估了3661个。随访时,88%的支架小梁被组织覆盖,组织厚度中位数为37.91μm(四分位间距:22.32 - 64.15)。新生内膜导致的支架内面积阻塞中位数为2.64%(四分位间距:1.70 - 4.84)。在整个支架覆盖区域中,92.3%显示支架小梁完全覆盖。74%的病例观察到组织均匀。基线和随访时最小管腔面积(5.07±1.08mm对4.81±0.94mm,P = 0.125)或最小支架面积(4.95±1.22mm对4.92±0.99mm)无差异。支架小梁贴壁不良率无差异(4.3%对5.7%,P = 0.417)。对于所有支架,基线时贴壁不良体积为47.9mm,随访时为51.7mm,晚期获得性支架贴壁不良体积为3.8mm。

结论

第二代耐用聚合物O-ZES在OCT 30天随访时显示出良好的血管愈合情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c1e/6727229/173d8b06f74a/PWKI-15-86009-g001.jpg

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