Neointimal coverage of sirolimus-eluting stents at 6-month follow-up: evaluated by optical coherence tomography
Neointimal coverage of sirolimus-eluting stents at 6-month follow-up: evaluated by optical coherence tomography
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DOI：
10.1093/eurheartj/ehl413
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发表时间：
2007-04-01
影响因子：
39.3
通讯作者：
Yokoyama, Mitsuhiro
中科院分区：
文献类型：
--
作者：
Matsumoto, Daisuke;Shite, Junya;Yokoyama, Mitsuhiro
目的：由于血管内超声（IVUS）在大多数西罗莫司洗脱支架（SES）的慢性期不能检测到新生内膜层，因此SES在多大程度上未被发现仍然存在争议。然而，具有优异分辨率的光学相干断层扫描（OCT）可能能够检测到较薄的新生内膜。方法与结果随访6个月，对34例患者（57例SES）行OCT和IVUS检查。评估每个SES支柱横截面上新内膜的厚度以及支柱与血管壁的相对位置。通过OCT评估，新生内膜厚度中位数（25、75百分位数）为52.5 μ m (28.0 μ m, 147.6 μ m)， IVUS检测不到的薄新生内膜覆盖的支路患病率为64%。在个体SES中，新内膜覆盖支撑物的平均比率为89%。9个支架（16%）被新生内膜完全覆盖，而其余支架有部分未发现的支架结构病变。在所有SES OCT显示的6840支支中，有79支支显示错位，没有内膜覆盖，并且经常在SES重叠区域观察到。结论在6个月时，大多数SES被薄的新生内膜覆盖，但很少被完全覆盖。
Aims Since the intravascular ultrasound (IVUS) cannot detect neointimal layers in the majority of sirolimus-eluting stents (SES) at the chronic phase, it is still controversial to what extent SES remain uncovered. However, optical coherence tomography (OCT) with excellent resolution may be able to detect thinner neointima.Methods and results A total of 34 patients (57 SES) underwent OCT and IVUS evaluations at 6-month follow-up. The thickness of neointima on each SES strut cross-section and strut apposition to the vessel wall was evaluated. By OCT evaluation, the median (25th, 75th percentiles) neointima thickness was 52.5 mu m (28.0 mu m, 147.6 mu m) and the prevalence of struts covered by thin neointima undetectable by IVUS was 64%. The average rate of neointima-covered struts in an individual SES was 89%. Nine SES (16%) showed full coverage by neointima, whereas the remaining stents had partially uncovered strut lesions. Among the 6840 struts visualized by OCT in all of the SES, 79 struts showed malapposition without neointimal coverage, and were frequently observed in the areas of SES overlap.Conclusion At 6 months, most of the SES were covered with thin neointima, but few showed full coverage.