Neointimal coverage of sirolimus-eluting stents at 6-month follow-up: evaluated by optical coherence tomography

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 d...

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Bibliographic Details
Published in:European heart journal 2007-04, Vol.28 (8), p.961-967
Main Authors: Matsumoto, Daisuke, Shite, Junya, Shinke, Toshiro, Otake, Hiromasa, Tanino, Yusuke, Ogasawara, Daisuke, Sawada, Takahiro, Paredes, Oscar Luis, Hirata, Ken-ichi, Yokoyama, Mitsuhiro
Format: Article
Language:English
Subjects:
Aged
Aspirin - therapeutic use
Catheterization
Cell Proliferation
Coronary Restenosis - drug therapy
Coronary Restenosis - pathology
Coronary Thrombosis - pathology
Drug Therapy, Combination
Female
Follow-Up Studies
Humans
Immunosuppressive Agents - administration & dosage
Male
Sirolimus - administration & dosage
Stents
Ticlopidine - therapeutic use
Tomography, Optical Coherence
Tunica Intima - pathology
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Summary: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 µm (28.0 µm, 147.6 µm) 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.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehl413