International Heart Journal
Online ISSN : 1349-3299
Print ISSN : 1349-2365
ISSN-L : 1349-2365
Clinical Studies
Early Vascular Healing Following Bioresorbable-Polymer Sirolimus-Eluting Stent Placement Compared to That with Durable-Polymer Everolimus-Eluting Stent
Sequential Optical Coherence Tomography Study
Kunihiro Ogura, Hiroaki Tsujita, Yosuke Oishi, Hidenari Matsumoto, Naoki Matsukawa, Rikuo Sakai, Taito Arai, Shunya Sato, Hideaki Tanaka, Ryota Masaki, Ken Arai, Kosuke Nomura, Ryota Kosaki, Koshiro Sakai, Teruo Sekimoto, Seita Kondo, Shigeto Tsukamoto, Hiroyoshi Mori, Myong Hwa Yamamoto, Kohei Wakabayashi, Hiroshi Suzuki, Masahiko Ochiai, Toshiro Shinke
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Keywords: Chronic coronary syndrome, Drug-eluting stent, Neointimal coverage, Intravascular imaging, Percutaneous coronary intervention
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2021 Volume 62 Issue 3 Pages 510-519

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Abstract

A recent thinner strut drug-eluting stent might facilitate early strut coverage after its placement. We aimed to investigate early vascular healing responses after the placement of an ultrathin-strut bioresorbable-polymer sirolimus-eluting stent (BP-SES) compared to those with a durable-polymer everolimus-eluting stent (DP-EES) using optical coherence tomography (OCT) imaging.

This study included 40 patients with chronic coronary syndrome (CCS) who underwent OCT-guided percutaneous coronary intervention (PCI). Twenty patients each received either BP-SES or DP-EES implantation. OCT was performed immediately after stent placement (baseline) and at 1-month follow-up.

At one month, the percentage of uncovered struts reduced significantly in both the BP-SES (80.9 ± 10.3% to 2.9 ± 1.7%; P < 0.001) and DP-EES (81.9 ± 13.0% to 5.7 ± 1.8%; P < 0.001) groups, and the percentage was lower in the BP-SES group than in the DP-EES group (P < 0.001). In the BP-SES group, the percentage of malapposed struts also decreased significantly at 1 month (4.9 ± 3.7% to 2.6 ± 3.0%; P = 0.025), which was comparable to that of the DP-EES group (2.5 ± 2.2%; P = 0.860). The optimal cut-off value of the distance between the strut and vessel surface immediately after the placement to predict resolved malapposed struts was ≤ 160 μm for BP-SES and ≤ 190 μm for DP-EES.

Compared to DP-EES, ultrathin-strut BP-SES demonstrated favorable vascular responses at one month, with a lower rate of uncovered struts and a comparable rate of malapposed struts.

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© 2021 by the International Heart Journal Association
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