open access

Vol 20, No 3 (2013)
Original articles
Published online: 2013-06-01
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Tissue coverage of paclitaxel and sirolimus eluting stents in long term follow-up: Optical coherence tomography study

Janusz Kochman, Arkadiusz Pietrasik, Adam Rdzanek, Anna Ścibisz, Maciej Pawlak, Krzysztof J. Filipiak, Grzegorz Opolski
DOI: 10.5603/CJ.2013.0069
·
Cardiol J 2013;20(3):247-253.

open access

Vol 20, No 3 (2013)
Original articles
Published online: 2013-06-01

Abstract

Background: Implantation of drug eluting stents (DES) has become a standard treatment ofpatients undergoing percutaneous coronary intervention (PCI). Incomplete strut coverage isa potential risk factor for late stent thrombosis. Optical coherence tomography (OCT) enablesin vivo identification of incomplete neointimal coverage.

Methods: Study included 62 patients after sirolimus eluting stents (SES) or paclitaxel elutingstents (PES) implantation. OCT examination was performed at least 24 months after theinitial procedure (35.4± 9.4 months). In cross-sectional still frames selected from each 1 mm ofanalyzed stents a total number of visible struts and number of struts with or without completeneointimal coverage was assessed. Measurements of neointimal coverage, presented as a meanthickness of tissue, were performed. Patients were followed up for 3 years and the frequency ofmajor adverse cardiac events was recorded.

Results: In the analyzed 28 SES and 37 PES 9998 struts were identified. Complete neointimalcoverage was observed in 83.5% and 79.2% of SES and PES struts respectively (p = 0.48).There was no difference in incidence of not covered or malapposed struts between SES and PES groups. Mean thickness of the tissue covering SES struts was 0.165 ± 0.095 mm, and 0.157 ± 0.121 mm for PES. The mean neointimal thickness difference (SES vs. PES) was notstatistically significant. In a 36 months follow-up 1 death was observed — potentially attributedto stent thrombosis.

Conclusions: A long term OCT follow-up after DES implantation shows high incidence ofuncovered struts regardless of the stent type. Clinical significance of this finding remains questionableand requires further large scale trials.

Abstract

Background: Implantation of drug eluting stents (DES) has become a standard treatment ofpatients undergoing percutaneous coronary intervention (PCI). Incomplete strut coverage isa potential risk factor for late stent thrombosis. Optical coherence tomography (OCT) enablesin vivo identification of incomplete neointimal coverage.

Methods: Study included 62 patients after sirolimus eluting stents (SES) or paclitaxel elutingstents (PES) implantation. OCT examination was performed at least 24 months after theinitial procedure (35.4± 9.4 months). In cross-sectional still frames selected from each 1 mm ofanalyzed stents a total number of visible struts and number of struts with or without completeneointimal coverage was assessed. Measurements of neointimal coverage, presented as a meanthickness of tissue, were performed. Patients were followed up for 3 years and the frequency ofmajor adverse cardiac events was recorded.

Results: In the analyzed 28 SES and 37 PES 9998 struts were identified. Complete neointimalcoverage was observed in 83.5% and 79.2% of SES and PES struts respectively (p = 0.48).There was no difference in incidence of not covered or malapposed struts between SES and PES groups. Mean thickness of the tissue covering SES struts was 0.165 ± 0.095 mm, and 0.157 ± 0.121 mm for PES. The mean neointimal thickness difference (SES vs. PES) was notstatistically significant. In a 36 months follow-up 1 death was observed — potentially attributedto stent thrombosis.

Conclusions: A long term OCT follow-up after DES implantation shows high incidence ofuncovered struts regardless of the stent type. Clinical significance of this finding remains questionableand requires further large scale trials.

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Keywords

PES, SES, restenosis, stent malapposition, stent expantion

About this article
Title

Tissue coverage of paclitaxel and sirolimus eluting stents in long term follow-up: Optical coherence tomography study

Journal

Cardiology Journal

Issue

Vol 20, No 3 (2013)

Pages

247-253

Published online

2013-06-01

DOI

10.5603/CJ.2013.0069

Bibliographic record

Cardiol J 2013;20(3):247-253.

Keywords

PES
SES
restenosis
stent malapposition
stent expantion

Authors

Janusz Kochman
Arkadiusz Pietrasik
Adam Rdzanek
Anna Ścibisz
Maciej Pawlak
Krzysztof J. Filipiak
Grzegorz Opolski

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