Neointimal coverage of zotarolimus-eluting stent at 1, 2, and 3 months' follow-up: an optical coherence tomography study
Neointimal coverage of zotarolimus-eluting stent at 1, 2, and 3 months' follow-up: an optical coherence tomography study
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DOI：
10.1007/s00380-014-0598-0
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发表时间：
2016-02-01
影响因子：
1.5
通讯作者：
Ako, Junya
中科院分区：
文献类型：
--
作者：
Hashikata, Takehiro;Tojo, Taiki;Ako, Junya
支架置入术后内膜覆盖不全和支架错位会增加支架血栓形成的风险。我们的目的是利用光学相干断层扫描（OCT）评估Resolute佐他莫司洗脱支架（R-ZES）植入后早期内膜覆盖情况。共纳入20例伴有R-ZES的新生冠状动脉病变患者。在这些患者中，19例患者的20个支架病变在R-ZES植入后1、2和3个月进行评估。采用oct检测支架贴壁和内膜覆盖率，每隔1 mm测量支架贴壁厚度、贴壁百分比和不完全贴壁比例。覆盖支架支撑物的平均百分比在3个月内超过85%（1个月时为88.4 +/- 6.3%，2个月时为95.5 +/- 5.5%，3个月时为93.6 +/- 3.5%）。各组间不完全对立支的百分比差异无统计学意义（1个月时为4.4 +/- 4.2%，2个月时为1.9 +/- 1.9%，3个月时为3.1 +/- 2.2%,p = 0.51）。2个月组的平均NIH厚度（1个月时为38.9 +/- 8.1 mu m， 2个月时为70.6 +/- 18.8 mu m， 3个月时为54.1 +/- 5.9 mu m, p = 0.0016）最大。大多数2个月内的OCT表现为低信号强度的内膜覆盖。ZES-R在3个月内的内膜覆盖率超过85%。这些数据可能支持较短的R-ZES双重抗血小板治疗时间要求。
Incomplete neointimal coverage and malapposed struts after stenting are associated with increased risk of stent thrombosis. We aimed to evaluate neointimal coverage early after Resolute zotarolimus-eluting stent (R-ZES) implantation using optical coherence tomography (OCT). A total of 20 patients with de novo native coronary lesions with R-ZES were enrolled. Among these patients, 20 stented lesions in 19 patients were evaluated at 1, 2, and 3 months after R-ZES implantation. The strut apposition and neointimal coverage were evaluated by OCT. Neointimal hyperplasia (NIH) thickness and percentage of covered struts and the proportion of incompletely apposed struts were measured at 1-mm intervals. The mean percentages of covered stent struts were over 85 % within 3 months (88.4 +/- 6.3 % at 1 month, 95.5 +/- 5.5 % at 2 months, 93.6 +/- 3.5 % at 3 months). The percentages of incompletely apposed struts were not significantly different among the groups (4.4 +/- 4.2 % at 1 month, 1.9 +/- 1.9 % at 2 months, 3.1 +/- 2.2 % at 3 months, p = 0.51). Mean NIH thickness (38.9 +/- 8.1 mu m at 1 month, 70.6 +/- 18.8 mu m at 2 months, 54.1 +/- 5.9 at 3 months, p = 0.0016) was thickest in the 2 months group. Most of all OCT findings within 2 months demonstrated neointimal coverage with low signal intensity. The neointimal coverage of ZES-R was over 85 % within 3 months. These data may support shorter requirement of dual antiplatelet therapy duration with R-ZES.