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超薄支柱可生物降解聚合物涂层西罗莫司洗脱支架植入后的愈合及早期支架覆盖情况:SiBi光学相干断层扫描研究

Healing and early stent coverage after ultrathin strut biodegradable polymer-coated sirolimus-eluting stent implantation: SiBi optical coherence tomography study.

作者信息

Abhyankar Atul, Abizaid Alexandre, Chamié Daniel, Patel Gaurang

机构信息

Department of Cardiology, Shree B. D. Mehta Mahavir Heart Institute, Surat, India.

Interventional Cardiology Department, University of São Paulo, São Paulo, Brazil.

出版信息

Catheter Cardiovasc Interv. 2021 Dec 1;98(7):1335-1342. doi: 10.1002/ccd.29371. Epub 2020 Nov 28.

DOI:10.1002/ccd.29371
PMID:33247618
Abstract

AIMS

The aim of SiBi study was to evaluate the early vascular healing and neointimal coverage after implantation of ultrathin (60 μm) biodegradable polymer-coated Tetriflex (Sahajanand Medical Technologies Pvt. Ltd., Surat, India) sirolimus-eluting stent (SES) using optical coherence tomography (OCT) at 4 to 6 weeks after implantation.

METHODS

SiBi was a single-center, observational, investigator-initiated study. From January 15, 2018 to April 15, 2018, total 29 consecutive patients who had consented and underwent OCT examination at 4-6 weeks after Tetriflex SES implantation were enrolled. All OCT images were analyzed at an independent core laboratory by analysts who were blinded to patient and procedural information.

RESULTS

Of 29 patients, four patients were excluded, as those OCT images were technically inadequate for analysis. Therefore, 25 patients were included in final OCT analysis. Average OCT analysis was performed after 35.3 ± 5 days of Tetriflex implantation. Total 14,024 stent struts in 1,520 cross sections were analyzed. Strut tissue coverage was observed in 91.26 ± 5.53% of struts and malapposed struts were seen in 0.89 ± 1.67%. The mean neointimal hyperplasia (NIH) thickness on the covered struts was 50 ± 30 μm.

CONCLUSION

A large percentage of struts were found to be covered with thin layer of NIH evenly distributed along the stent length at around 1 month from stent implantation. The results of this pilot study serve as ethical and scientific backbone to conduct an adequately powered clinical trial to evaluate outcomes of short dual-antiplatelet therapy in context of ultrathin strut stent.

摘要

目的

SiBi研究的目的是使用光学相干断层扫描(OCT)在植入超薄(60μm)可生物降解聚合物涂层的Tetriflex(印度苏拉特Sahajanand医疗技术有限公司)西罗莫司洗脱支架(SES)后4至6周评估早期血管愈合和新生内膜覆盖情况。

方法

SiBi是一项单中心、观察性、研究者发起的研究。从2018年1月15日至2018年4月15日,共有29例连续患者在Tetriflex SES植入后4至6周同意并接受了OCT检查。所有OCT图像均由对患者和手术信息不知情的分析人员在独立的核心实验室进行分析。

结果

29例患者中,有4例患者被排除,因为那些OCT图像在技术上不足以进行分析。因此,25例患者被纳入最终的OCT分析。平均在Tetriflex植入后35.3±5天进行OCT分析。共分析了1520个横截面中的14024个支架支柱。观察到91.26±5.53%的支柱有支柱组织覆盖,0.89±1.67%的支柱有贴壁不良。覆盖支柱上的平均新生内膜增生(NIH)厚度为50±30μm。

结论

在支架植入后约1个月时,发现很大比例的支柱被一层沿支架长度均匀分布的薄薄的NIH覆盖。这项初步研究的结果为开展一项有足够效力的临床试验提供了伦理和科学依据,以评估超薄支柱支架情况下短期双联抗血小板治疗的结果。

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