Two-year follow-up of the quantitative anglographic and volumetric intravascular ultrasound analysis after nonpolymeric paclitaxel-eluting stent implantation - Late "catch-up" phenomenon from ASPECT study
Two-year follow-up of the quantitative anglographic and volumetric intravascular ultrasound analysis after nonpolymeric paclitaxel-eluting stent implantation - Late "catch-up" phenomenon from ASPECT study
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DOI：
10.1016/j.jacc.2006.08.033
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发表时间：
2006-12-19
影响因子：
24
通讯作者：
Park, Seung-Jung
中科院分区：
文献类型：
--
作者：
Park, Duk-Woo;Hong, Myeong-Ki;Park, Seung-Jung
本研究使用连续血管造影和血管内超声（IVUS）分析来评价非聚合物，紫杉醇洗脱支架涂层对内膜增生（IH）植入后2年背景长期疗效的患者治疗非多聚紫杉醇洗脱支架超过1年尚未得到很好的确定。（低剂量，1.28 μ g/mm（2）;高剂量，3.10 μ g/mm（2））。53例患者（分别为17例、17例和19例）获得了完整的术后、6个月和2年血管造影和IVUS数据。尽管与紫杉醇洗脱支架患者相比，安慰剂组6个月最小管腔直径（MLD）显着较小（安慰剂组1.9 ± 0.6 mm，低剂量组2.5 ± 0.6 mm，高剂量组2.6 ± 0.5圈，p = 0.004），2年时的MLD相似（分别为2.3 ± 0.6 mm、2.3 ± 0.7 mm和2.0 ± 0.8 mm，p = 0.4）。尽管6个月时IH累积逐步减少（安慰剂组23 +/- 18转3，低剂量组14 +/- 11 mm 3，高剂量组10 12 mm 3，p = 0.017），高剂量组患者从6个月到2年的114体积增加显著更大（高剂量组13 +/- 14 mm（3）vs.低剂量组4 +/- 7 mm（3），p = 0.074;安慰剂组1 +/- 13 mm（3），p = 0.019）。晚期靶病变血运重建（超过1年）在2个高剂量patients.CONCLUSIONS尽管抑制IH后，非聚合物紫杉醇洗脱支架与裸金属支架相比，在6个月，“后期追赶”IH增长被发现在高剂量患者在2年的随访。
OBJECTIVES This study used serial angiographic and intravascular ultrasound (IVUS) analysis to evaluate the long-term efficacy of a nonpolymeric, paclitaxel-eluting stent coating on intimal hyperplasia (IH) 2 years after implantation.BACKGROUND Long-term efficacy of patients treated with nonpolyrneric paclitaxel-eluting stents beyond 1 year has not been well determined.METHODS Patients were randomized to placebo or 1 of 2 doses of paclitaxel (low dose, 1.28 mu g/mm(2); high dose, 3.10 mu g/mm(2)). Complete after-procedure, 6-month, and 2-year angiographic and IVUS data were available in 53 patients (17, 17, and 19 patients, respectively).RESULTS Baseline characteristics were similar among the 3 groups. Although 6-month minimal luminal diameter (MLD) was significantly smaller in placebo compared with paclitaxel-eluting stent patients (1.9 +/- 0.6 mm in placebo, 2.5 +/- 0.6 mm in low-dose, and 2.6 +/- 0.5 turn in high-dose patients, p = 0.004), the MLDs at 2 years were similar (2.3 +/- 0.6 mm, 2.3 +/- 0.7 mm, and 2.0 +/- 0.8 mm, respectively, p = 0.4). Despite a stepwise reduction in IH accumulation at 6 months (23 +/- 18 turn 3 in placebo, 14 +/- 11 mm(3) in low-dose, and 10 12 mm 3 in high-dose, p = 0.017), the increase of 114 volume from 6 months to 2 years was significantly greater in the high-dose patients (13 +/- 14 mm(3) in high-dose vs. 4 +/- 7 mm(3) in low-dose patients, p = 0.074; and vs. 1 +/- 13 mm(3) in placebo, p = 0.019). Late target lesion revascularization (beyond 1 year) was performed in 2 high-dose patients.CONCLUSIONS Despite the suppression of IH after non-polymeric paclitaxel-eluting stents compared with bare-metal stents at 6 months, a "late catch-up" IH growth was found in the high-dose patients at 2-year follow-up.