Department of Cardiology, Nagano Municipal Hospital, 1333-1, Tomitake, Nagano, 381-0006, Japan.
Department of Cardiovascular Medicine, Shinshu University Hospital, Matsumoto, Japan.
Cardiovasc Interv Ther. 2021 Jul;36(3):281-288. doi: 10.1007/s12928-020-00689-9. Epub 2020 Jul 3.
This study aimed to evaluate the early vascular response of ultra-thin strut bioresorbable polymer sirolimus-eluting stents (BP SES) using optical frequency domain imaging (OFDI). Ultra-thin strut BP SES have superior outcomes in terms of efficacy and safety endpoints when compared to other thin strut new-generation stents. However, the factors contributing to the superiority of BP SES over other thin strut new-generation stents are unclear. A total of 32 patients with multivessel disease requiring staged procedures at 1 month were enrolled from 3 cardiovascular institutions; of these, 31 were immediately assessed by OFDI (n = 31). All patients were assessed at 1 month after ultra-thin strut BP SES implantation. The primary endpoint was % of uncovered struts. A total of 1723 cross sections (17,014 struts) were analyzed at baseline and 1 month after percutaneous coronary intervention. The % uncovered struts at 1-month follow-up was 7.7% (4.0, 13.8). Furthermore, the covered strut % (88.4% and 80.4%, P = 0.013) and malapposition rate (2.7% and 4.3%, P = 0.012) were significantly different between the 60-μm and 80-μm stents. Ultra-thin strut BP SES implantation may feasibly achieve early vascular responses due to the ultra-thin struts. This may ultimately lead to lower stent thrombosis and target lesion failure rates.Clinical trial registration University Hospital Medical Information Network Clinical Trials Registry (No. UMIN000033406).
本研究旨在使用光频域成像(OFDI)评估超亲生物可吸收聚合物西罗莫司洗脱支架(BP SES)的早期血管反应。与其他薄壁新一代支架相比,超薄壁 BP SES 在疗效和安全性终点方面具有优势。然而,导致 BP SES 优于其他薄壁新一代支架的因素尚不清楚。这项研究共纳入了 3 家心血管机构的 32 名多支血管病变患者,这些患者需要在 1 个月内进行分期手术;其中 31 名患者立即接受 OFDI 评估(n=31)。所有患者在植入超薄壁 BP SES 后 1 个月进行评估。主要终点是未覆盖支架的百分比。基线和经皮冠状动脉介入治疗 1 个月后分析了总共 1723 个横截面(17014 个支架)。1 个月随访时未覆盖支架的百分比为 7.7%(4.0,13.8)。此外,在 60μm 和 80μm 支架之间,覆盖支架的百分比(88.4%和 80.4%,P=0.013)和贴壁不良率(2.7%和 4.3%,P=0.012)差异有统计学意义。超薄壁 BP SES 植入可能由于支架超薄而实现早期血管反应。这最终可能导致支架血栓形成和靶病变失败率降低。临床试验注册 大学医院医疗信息网临床试验注册(注册号 UMIN000033406)。