Comparative analysis of intimal hyperplasia after sirolimus-eluting stent and thin-strut bare-metal stent implantation in small coronary arteries

• Published in: Arquivos brasileiros de cardiologia 2006-04, Vol.86 (4), p.268-275
• Main Authors: Devito, Fernando Stuchi, Sousa, Amanda G M R, Feres, Fausto, Abizaid, Alexandre Antonio Cunha, Staico, Rodolfo, Mattos, Luis Alberto Piva, Tanajura, Luis Fernando Leite, Abizaid, Andréa C L S, Chaves, Aurea Jacob, Sousa, J Eduardo M R
• Format: Article
• Language: eng ; por
• Subjects: Adolescent; Adult; Angioplasty, Balloon, Coronary - methods; Angioplasty, Balloon, Coronary - standards; Antibiotics, Antineoplastic - administration & dosage; Coronary Restenosis - prevention & control; Coronary Stenosis - drug therapy; Coronary Stenosis - pathology; Drug Implants; Female; Follow-Up Studies; Humans; Hyperplasia - drug therapy; Hyperplasia - pathology; Male; Metals; Middle Aged; Prospective Studies; Sirolimus - administration & dosage; Stents; Tunica Intima - pathology
• ISSN: 0066-782X
• DOI: 10.1590/s0066-782x2006000400006

This study aimed at evaluating reduction in intimal hyperplasia volume following angioplasty using sirolimus-eluting stents (Cypher) compared with thin-strut bare-metal stents (Pixel) in patients with small vessels. Eighty patients with coronary artery disease were prospectively included in two consecutive series, the first using sirolimus-eluting stents (50) and the second using bare-metal stents (30). The use of sirolimus-eluting stents reduced: in-stent net volume obstruction [5.0% (SE = 0.77) x 39.0% (SE = 4.72), p < 0.001], in-stent late loss [0.25 mm (SE = 0.03) x 1,11 mm (SE = 0.13), p < 0.001], in-segment late loss [0.30 mm (SE = 0.04) x 0.83 mm (SE = 0.11), p < 0.001], in-stent restenosis (0% x 33.3%, p < 0.001) and in-segment restenosis (4% x 36.7%, p < 0.001). The event-free survival rate was 96% in the sirolimus-eluting stent group versus 86.7% in the bare-metal stent group (BMS) (p = 0.190). Sirolimus-eluting stents are superior to thin-strut bare-metal stents in reducing intimal hyperplasia (less in-stent obstruction and less late lumen loss) in patients with small vessels. The use of these stents significantly reduced angiographic restenosis at eight months.