Tsujimura Takuya, Ishihara Takayuki, Iida Osamu, Hata Yosuke, Toyoshima Taku, Higashino Naoko, Kurata Naoya, Asai Mitsutoshi, Masuda Masaharu, Okamoto Shin, Nanto Kiyonori, Kanda Takashi, Matsuda Yasuhiro, Mano Toshiaki
Kansai Rosai Hospital Cardiovascular Center Amagasaki Japan.
Department of Clinical Engineering, Kansai Rosai Hospital Amagasaki Japan.
Circ Rep. 2021 May 29;3(6):316-323. doi: 10.1253/circrep.CR-21-0053.
The Orsiro ultrathin-strut, biodegradable-polymer, sirolimus-eluting stent (O-SES) has specific characteristics regarding its components and has demonstrated comparable clinical outcomes compared with durable-polymer, drug-eluting stents (DES). However, arterial repair following deployment of the O-SES has not been elucidated to date. Using data from the Kansai Rosai Hospital database between November 2010 and September 2020, we analyzed coronary angioscopy (CAS) findings a mean (±SD) of 10±2 months after implantation of an O-SES, a durable-polymer everolimus-eluting stent (Xience; X-EES), or a biodegradable-polymer everolimus-eluting stent (Synergy; S-EES). Neointimal coverage (NIC), yellow color intensity of the stented segment, and the incidence of thrombus adhesion were compared between the O-SES (66 stents from 42 patients), X-EES (119 stents from 87 patients), and S-EES (132 stents from 88 patients). NIC was significantly thinner for the O-SES than S-EES (P<0.001), but was similar between the O-SES and X-EES (P=0.25). Yellow color intensity was significantly greater for the O-SES than X-EES (P<0.001), but similar between the O-SES and S-EES (P=0.51). The incidence of thrombus adhesions was similar in all 3 groups. O-SES and X-EES resulted in similar inhibition of NIC and both resulted in a thinner NIC than with S-EES. In addition, O-SES exhibited a similar degree of thrombus adhesion as the other DES, suggesting similar thrombogenicity.
奥西罗超薄支柱、可生物降解聚合物、西罗莫司洗脱支架(O-SES)在其组件方面具有特定特征,并且与耐用聚合物药物洗脱支架(DES)相比已显示出相当的临床结果。然而,迄今为止,O-SES植入后的动脉修复情况尚未阐明。利用2010年11月至2020年9月关西罗萨医院数据库中的数据,我们分析了在植入O-SES、耐用聚合物依维莫司洗脱支架(Xience;X-EES)或可生物降解聚合物依维莫司洗脱支架(Synergy;S-EES)后平均(±标准差)10±2个月的冠状动脉血管内镜检查(CAS)结果。比较了O-SES(来自42例患者的66个支架)、X-EES(来自87例患者的119个支架)和S-EES(来自88例患者的132个支架)之间的新生内膜覆盖率(NIC)、支架段的黄色强度以及血栓粘附发生率。O-SES的NIC明显比S-EES薄(P<0.001),但O-SES和X-EES之间相似(P=0.25)。O-SES的黄色强度明显大于X-EES(P<0.001),但O-SES和S-EES之间相似(P=0.51)。所有3组的血栓粘附发生率相似。O-SES和X-EES对NIC的抑制作用相似,且两者导致的NIC均比S-EES薄。此外,O-SES表现出与其他DES相似程度的血栓粘附,表明血栓形成性相似。