Comparison of early-phase arterial repair following cobalt-chrome everolimus-eluting stent and slow-release zotarolimus-eluting stent: an angioscopic study
- 128 Downloads
Whether arterial repair following implantation of drug-eluting stents (DES) of the second generation differs among stent types remains unknown. We examined 41 DES placed in 28 patients (age 72 ± 7 years, male 89%) presenting with stable angina pectoris due to de novo lesions in native coronary arteries. Coronary angioscopy was performed 4 ± 1 months after stent implantation. Patients were divided into two groups based on the DES types: 22 cobalt-chrome everolimus-eluting stents (CoCr-EES) in 13 patients and 19 slow-release zotarolimus-eluting stents (R-ZES) in 15 patients. Neointimal coverage (NIC) was graded as: grade 0, stent struts exposed; grade 1, struts bulging into the lumen, although covered; grade 2, struts embedded in the neointima, but translucent; grade 3, struts fully embedded and invisible. NIC was defined as heterogeneous when the NIC grade variation was ≥1. Presence of thrombus was also investigated. Distribution of dominant NIC grade (CoCr-EES: grade 0, 9%; grade 1, 77%; grade 2, 9%; grade 3, 5%; R-ZES: grade 0, 16%; grade 1: 47%; grade 2, 37%; grade 3, 0%, P = 0.38) and heterogeneity of NIC (P = 0.43) were similar between CoCr-EES and R-ZES groups. Existence of thrombus was not significantly different in CoCr-EES and R-ZES (18 versus 42%, P = 0.17). Arterial repair occurred without significant differences between CoCr-EES and R-ZES 4 months after implantation.
KeywordsAngioscopy Arterial repair Drug-eluting stent
We acknowledge the expertise of Drs. Shota Okuno, Yasuhiro Matsuda and Koji Yanaka in performing cardiac catheterization.
Compliance with ethical standards
Conflict of interest
The authors have no conflict of interest to declare.
- 1.Iqbal J, Serruys PW, Silber S, Kelbaek H, Richardt G, Morel MA, et al. Comparison of zotarolimus- and everolimus-eluting coronary stents: final 5-year report of the RESOLUTE all-comers trial. Circ Cardiovasc Interv. 2015;8:e002230. doi: 10.1161/CIRCINTERVENTIONS.114.002230.CrossRefPubMedGoogle Scholar
- 3.Navarese EP, Tandjung K, Claessen B, Andreotti F, Kowalewski M, Kandzari DE, et al. Safety and efficacy outcomes of first and second generation durable polymer drug eluting stents and biodegradable polymer biolimus eluting stents in clinical practice: comprehensive network meta-analysis. BMJ. 2013;347:f6530.CrossRefPubMedPubMedCentralGoogle Scholar
- 4.Levine GN, Bates ER, Bittl JA, Brindis RG, Fihn SD, Fleisher LA, et al. 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines: an update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention, 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery, 2012 ACC/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients with Stable Ischemic Heart Disease, 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction, 2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes, and 2014 ACC/AHA Guideline on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery. Circulation. 2016;134:e123–55. doi: 10.1161/CIR.0000000000000404.CrossRefPubMedGoogle Scholar
- 10.den Heijer P, Foley DP, Hillege HL, Lablanche JM, van Dijk RB, Franzen D, European Working Group on Coronary Angioscopy, et al. The ‘Ermenonville’ classification of observations at coronary angioscopy—evaluation of intra- and inter-observer agreement. European Working Group on Coronary Angioscopy. Eur Heart J. 1994;15:815–22.CrossRefGoogle Scholar
- 11.Dai K, Matsuoka H, Kawakami H, Sato T, Watanabe K, Nakama Y, et al. Comparison of chronic angioscopic findings of bare metal stents, 1st-generation drug-eluting stents and 2nd-generation drug-eluting stents—Multicenter Study of Intra-Coronary Angioscopy After Stent (MICASA). Circ J. 2016;80:1916–21.CrossRefPubMedGoogle Scholar
- 14.Haase J, Escaned J, van Swijndregt EM, Ozaki Y, Gronenschild E, Slager CJ, et al. Experimental validation of geometric and densitometric coronary measurements on the new generation Cardiovascular Angiography Analysis System (CAAS II). Cathet Cardiovasc Diagn. 1993;30:104–14.CrossRefPubMedGoogle Scholar
- 19.Natsuaki M, Morimoto T, Yamamoto E, Shiomi H, Furukawa Y, Abe M, et al. One-year outcome of a prospective trial stopping dual antiplatelet therapy at 3 months after everolimus-eluting cobalt-chromium stent implantation: shortT and OPtimal duration of Dual AntiPlatelet Therapy after everolimus-eluting cobalt-chromium stent (STOPDAPT) trial. Cardiovasc Interv Ther. 2016;31:196–209.CrossRefPubMedGoogle Scholar
- 21.Schwartz RS. Pathophysiology of restenosis: interaction of thrombosis, hyperplasia, and/or remodeling. Am J Cardiol. 1998;81:14E−17E. http://www.ajconline.org/. Accessed 31 Oct 2016.