Division of Cardiology, Department of Medicine, Showa University School of Medicine.
Department of Legal Medicine, Showa University School of Medicine.
Int Heart J. 2021 May 29;62(3):510-519. doi: 10.1536/ihj.20-627. Epub 2021 May 15.
A recent thinner strut drug-eluting stent might facilitate early strut coverage after its placement. We aimed to investigate early vascular healing responses after the placement of an ultrathin-strut bioresorbable-polymer sirolimus-eluting stent (BP-SES) compared to those with a durable-polymer everolimus-eluting stent (DP-EES) using optical coherence tomography (OCT) imaging.This study included 40 patients with chronic coronary syndrome (CCS) who underwent OCT-guided percutaneous coronary intervention (PCI). Twenty patients each received either BP-SES or DP-EES implantation. OCT was performed immediately after stent placement (baseline) and at 1-month follow-up.At one month, the percentage of uncovered struts reduced significantly in both the BP-SES (80.9 ± 10.3% to 2.9 ± 1.7%; P < 0.001) and DP-EES (81.9 ± 13.0% to 5.7 ± 1.8%; P < 0.001) groups, and the percentage was lower in the BP-SES group than in the DP-EES group (P < 0.001). In the BP-SES group, the percentage of malapposed struts also decreased significantly at 1 month (4.9 ± 3.7% to 2.6 ± 3.0%; P = 0.025), which was comparable to that of the DP-EES group (2.5 ± 2.2%; P = 0.860). The optimal cut-off value of the distance between the strut and vessel surface immediately after the placement to predict resolved malapposed struts was ≤ 160 μm for BP-SES and ≤ 190 μm for DP-EES.Compared to DP-EES, ultrathin-strut BP-SES demonstrated favorable vascular responses at one month, with a lower rate of uncovered struts and a comparable rate of malapposed struts.
近期出现的一种更薄的支架梁药物洗脱支架,可能有利于支架置入后早期的支架梁覆盖。我们旨在通过光学相干断层扫描(OCT)成像,研究超亲脂性可降解聚合物西罗莫司洗脱支架(BP-SES)与持久性聚合物依维莫司洗脱支架(DP-EES)置入后早期血管愈合反应的差异。
这项研究纳入了 40 名慢性冠脉综合征(CCS)患者,他们接受了 OCT 引导下的经皮冠状动脉介入治疗(PCI)。每组各 20 名患者分别接受 BP-SES 或 DP-EES 植入。支架置入后即刻(基线)和 1 个月随访时进行 OCT 检查。
1 个月时,BP-SES(80.9±10.3%降至 2.9±1.7%;P<0.001)和 DP-EES(81.9±13.0%降至 5.7±1.8%;P<0.001)两组的未覆盖支架梁比例均显著降低,且 BP-SES 组低于 DP-EES 组(P<0.001)。BP-SES 组 1 个月时,错位支架梁比例也显著降低(4.9±3.7%降至 2.6±3.0%;P=0.025),与 DP-EES 组相似(2.5±2.2%;P=0.860)。支架梁置入即刻时支架梁与血管壁之间的距离,预测未解决的错位支架梁的最佳截断值为 BP-SES 组≤160μm,DP-EES 组≤190μm。
与 DP-EES 相比,超亲脂性可降解聚合物 BP-SES 在 1 个月时表现出更好的血管反应,未覆盖支架梁比例较低,且错位支架梁比例相似。