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Comparison of vascular responses after different types of second-generation drug-eluting stents implantation detected by optical coherence tomography

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Abstract

Few studies have directly compared vascular responses to second-generation drug-eluting stents (DESs). We performed optical coherence tomography examinations in 56 consecutive patients with implanted single stent [19 cobalt-chromium everolimus-eluting stents (CoCr-EES), 22 platinum-chromium EES (PtCr-EES), and 15 resolute zotarolimus-eluting stents (R-ZES)] for de novo lesions, and who did not have restenosis at their 9-month follow-up. Neointimal thickness (NIT), stent apposition, and neointimal coverage were assessed in every strut. A neointimal unevenness score [(NUS), maximum NIT/average NIT in the same cross-section] was determined for every 1-mm cross-section (CS). A total of 8350 struts and 1159 CSs were analyzed. The CoCr- and PtCr-EES had significantly fewer malapposed struts compared to the R-ZES (CoCr-EES: 0.19 % vs. PtCr-EES: 0.19 % vs. R-ZES: 0.61 %, p = 0.007). Furthermore, the PtCr-EES had a lower frequency of uncovered struts compared to the others (CoCr-EES: 2.0 % vs. PtCr-EES: 1.4 % vs. R-ZES: 2.3 %, p = 0.047). The NUS correlated with the frequency of uncovered struts (p < 0.001, r = 0.54). The EESs demonstrated more homogenous neointimal growth, as shown in the NUS, compared to the R-ZES [CoCr-EES: 1.66 (1.38–1.97) vs. PtCr-EES: 1.67 (1.41–2.00) vs. R-ZES: 1.94 (1.56–2.28), p < 0.001]. Our results demonstrate that unevenness neointimal growth may relate with strut coverage after second-generation DES implantation. The PtCr-EES had a high frequency of strut coverage with a homogeneous neointima, suggesting fewer risks for stent thrombosis.

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Authors and Affiliations

  1. Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Japan

    Hirofumi Ohtani, Shigeki Kimura, Tomoyo Sugiyama, Keiichi Hishikari, Toru Misawa, Masafumi Mizusawa, Kazuto Hayasaka, Yosuke Yamakami, Keisuke Kojima, Yuichiro Sagawa, Hiroyuki Hikita & Atsushi Takahashi

  2. Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan

    Takashi Ashikaga & Mitsuaki Isobe

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  1. Hirofumi Ohtani
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  2. Shigeki Kimura
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  3. Tomoyo Sugiyama
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Correspondence to Shigeki Kimura.

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Ohtani, H., Kimura, S., Sugiyama, T. et al. Comparison of vascular responses after different types of second-generation drug-eluting stents implantation detected by optical coherence tomography. Int J Cardiovasc Imaging 33, 177–186 (2017). https://doi.org/10.1007/s10554-016-1001-2

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  • DOI: https://doi.org/10.1007/s10554-016-1001-2

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