Serial long-term evaluation of neointimal stent coverage and thrombus after sirolimus-eluting stent implantation by use of coronary angioscopy
Serial long-term evaluation of neointimal stent coverage and thrombus after sirolimus-eluting stent implantation by use of coronary angioscopy
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DOI：
10.1136/hrt.2007.132555
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发表时间：
2007-11-01
期刊：
影响因子：
5.7
通讯作者：
Mizuno, Kyoichi
中科院分区：
文献类型：
--
作者：
Takano, Masamichi;Yamamoto, Masanori;Mizuno, Kyoichi
目的：方法：在20例患者的20个节段中，分别于术前、术后6个月和术后2年行冠状动脉血管镜检查，观察西罗莫司洗脱支架（SES）植入后2年内新生内膜支架覆盖率（NSC）的变化和血栓的变化。NSC分类如下：0，未覆盖支柱; 1，可见支柱穿过薄的新生内膜;或2，无可见支柱。在每例患者中，评价了最大和最小NSC。结果：从6个月到2年，最大NSC增加（平均值（SD）分别为1.2（0.4）vs 1.8（0.4），p = 0.005），而最小NSC没有变化（分别为0.7（0.5）vs 0.8（0.4），p = 0.25）。从6个月到2年，支柱未覆盖患者的患病率没有降低（分别为35%和20%，p = 0.29）。虽然没有血栓相关的不良事件，但在6个月和2年随访评价中分别有5%和20%的患者发现新的血栓形成。基线、6个月和2年时SES内血栓的患病率相似（分别为40%、40%和30%; p = NS）。结论：SES内新生内膜生长进展不均匀。20%的患者的未覆盖支柱持续长达2年，亚临床血栓形成并不罕见。
Objective: Progression of neointimal stent coverage ( NSC) and changes in thrombus were evaluated serially by coronary angioscopy for up to 2 years after sirolimus- eluting stent ( SES) implantation.Methods: Serial angioscopic observations were performed in 20 segments of 20 patients at baseline, at 6 months and at 2 years after SES implantation. NSC was classified as follows: 0, uncovered struts; 1, visible struts through thin neointima; or 2, no visible struts. In each patient, maximum and minimum NSC was evaluated. Existence of thrombus was also examined.Results: The maximum NSC increased from 6 months to 2 years ( mean ( SD) 1.2 ( 0.4) vs 1.8 ( 0.4), respectively, p = 0.005), while the minimum NSC did not change ( 0.7 ( 0.5) vs 0.8 ( 0.4), respectively, p = 0.25). The prevalence of patients with uncovered struts did not decrease from 6 months to 2 years ( 35% vs 20%, respectively, p = 0.29). Although there were no thrombus- related adverse events, new thrombus formation was found in 5% of 6- month, and in 20% of 2- year follow- up evaluations. The prevalence of thrombus inside the SES at baseline, 6 months and 2 years was similar ( 40%, 40% and 30%, respectively; p = NS).Conclusions: Neointimal growth inside the SES progressed heterogeneously. Uncovered struts persisted in 20% of the patients for up to 2 years and subclinical thrombus formation was not uncommon.