Comparison of neointimal coverage and extra-stent lumen between sirolimus and everolimus-eluting stent using optical coherence tomography.
Comparison of neointimal coverage and extra-stent lumen between sirolimus and everolimus-eluting stent using optical coherence tomography.
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使用光学相干断层扫描比较西罗莫司和依维莫司洗脱支架的新内膜覆盖率和支架外管腔。
DOI：
10.1007/s00380-015-0630-z
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发表时间：
2015
期刊：
影响因子：
1.5
通讯作者：
Yano M
中科院分区：
文献类型：
--
作者：
Oda T;Okamura T;Yamada J;Miyagi N;Uehara H;Nao T;Tateishi H;Maeda T;Nakamura T;Shiraishi K;Nakashima T;Nishimura S;Miura T;Matsuzaki M;Yano M
光学相干断层扫描（OCT）评估的支架外腔（定义为支架外腔（ESL））可能与西罗莫司洗脱支架（SES）植入后血栓形成的风险有关。依维莫司洗脱支架（EES）可能提供相对最小的炎症反应和适当的内膜覆盖。本研究的目的是比较SES和EES之间的内膜厚度和ESL。在SES或EES植入后超过7个月接受OCT检查的患者被纳入研究。在支架段之间间隔1mm测量支架面积（SA）、管腔面积（LA）、新内膜面积（NIA）和新内膜厚度（NIT）。分析ESL的面积、角度（每横截面之和）和深度（邻近血管表面到支架轮廓的最大距离）。共纳入49个病灶（SESn= 20, esn = 29）。平均随访11个月。共分析了998个截面和9874个支板。两组支架面积、管腔面积和内膜面积无差异（SA: 6.01±1.60 vs 6.02±1.40 mm2,p= 0.572; LA: 5.37±1.52 vs 5.29±1.34 mm2,p= 0.692; NIA: 0.64±0.49 vs 0.72±0.37 mm2,p= 0.493）。SES组和EES组的平均NIT分别为0.11±0.05 mm和0.10±0.05 mm （p= 0.367）。相反，SES组ESL的面积、角度和深度均显著大于EES组（0.20±0.39比0.03±0.09 mm2,p< 0.001; 56.2±59.1°比20.1±41.9°，p< 0.001; 0.10±0.09比0.03±0.03 mm,p< 0.001）。OCT显示SES与EES对新生内膜生长的抑制效果相似，而EES植入后血管不良反应小于SES植入后。
The external lumen of a stent [defined as extra-stent lumen (ESL)] assessed by optical coherence tomography (OCT) may be related to the risk of thrombus formation after sirolimus-eluting stent (SES) implantation. An everolimus-eluting stent (EES) might provide relatively minimal inflammatory reaction and appropriate neointimal coverage. The purpose of this study was to compare the neointimal thickness and ESL between SES and EES. Patients who underwent OCT examination more than 7 months after either SES or EES implantation were enrolled. Stent area (SA), lumen area (LA), neointimal area (NIA) and neointimal thickness (NIT) of each strut were measured at 1-mm intervals between stented segments. The area, angle (summation per cross-section) and depth (maximum distance from adjacent vessel surface to the outline of stent) of ESL were analyzed. A total of 49 lesions were included (SESn= 20, EESn= 29). Mean follow-up period was 11 months. A total of 998 cross-sections and 9874 struts were analyzed. There were no differences in stent area, lumen area and neointimal area (SA: 6.01 ± 1.60 vs. 6.02 ± 1.40 mm2,p= 0.572, LA: 5.37 ± 1.52 vs. 5.29 ± 1.34 mm2,p= 0.692, NIA: 0.64 ± 0.49 vs. 0.72 ± 0.37 mm2,p= 0.493). Mean NIT of SES and EES were 0.11 ± 0.05 and 0.10 ± 0.05 mm, respectively (p= 0.367). Conversely, area, angle and depth of ESL in SES group were significantly greater than those in EES group (0.20 ± 0.39 vs. 0.03 ± 0.09 mm2,p< 0.001, 56.2 ± 59.1° vs. 20.1 ± 41.9°,p< 0.001, 0.10 ± 0.09 vs. 0.03 ± 0.03 mm,p< 0.001). OCT showed that the efficacy of neointimal growth suppression is similar between SES and EES, whereas the adverse vascular response after EES implantation is smaller than that after SES implantation.