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Satisfactory arterial repair 1 year after ultrathin strut biodegradable polymer sirolimus-eluting stent implantation: an angioscopic observation

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Abstract

The ultrathin strut biodegradable polymer sirolimus-eluting stent (Orsiro, O-SES) exhibits satisfactory clinical outcomes. However, no report to date has documented the intravascular status of artery repair after O-SES implantation. We examined 5 O-SES placed in 4 patients (age 65 ± 12 years, male 75%) presenting with stable angina pectoris due to de novo lesions in native coronary arteries. Coronary angioscopy was performed immediately after percutaneous coronary intervention and 1 year later. Angioscopic images were analyzed to determine the following: (1) dominant grade of neointimal coverage (NIC) over the stent; (2) maximum yellow plaque grade; and (3) existence of thrombus. Yellow plaque grade was evaluated both immediately after stent implantation and at the time of follow-up observation. The other parameters were evaluated at the time of follow-up examination. 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. Yellow plaque severity was graded as: grade 0, white; grade 1, light yellow; grade 2, yellow; and grade 3, intensive yellow. Angioscopic findings at 1 year demonstrated the following: dominant NIC grade 1, grade 2, and grade 3 in 1, 2, and 2 stents, respectively; all stents were covered to some extent; focal thrombus adhesion was observed in only 1 stent. Yellow plaque grade did not change from immediately after stent implantation to follow-up. O-SES demonstrated satisfactory arterial repair 1 year after implantation.

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Authors and Affiliations

  1. Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan

    Takayuki Ishihara, Osamu Iida, Masaharu Masuda, Shin Okamoto, Kiyonori Nanto, Takashi Kanda, Takuya Tsujimura & Toshiaki Mano

  2. Department of Cardiovascular Medicine, Osaka National Hospital, Osaka, Japan

    Masaki Awata

  3. Onco-Cardiology Unit, Department of Cardiovascular Medicine, Osaka International Cancer Institute, Osaka, Japan

    Masashi Fujita

  4. Institute for Clinical Research, Osaka National Hospital, Osaka, Japan

    Masaaki Uematsu

Authors
  1. Takayuki Ishihara
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  2. Masaki Awata
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  3. Osamu Iida
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  4. Masashi Fujita
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  5. Masaharu Masuda
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  6. Shin Okamoto
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  7. Kiyonori Nanto
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  8. Takashi Kanda
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  9. Takuya Tsujimura
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  10. Masaaki Uematsu
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  11. Toshiaki Mano
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Correspondence to Takayuki Ishihara.

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Electronic supplementary material

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12928_2018_510_MOESM1_ESM.mpg

Angioscopic image of ultrathin strut biodegradable polymer sirolimus-eluting Stent (O-SES) 385 days after implantation (case number 1). Coronary angioscopic observation 1 year after O-SES (2.5 mm diameter by 18 mm length) implantation in the distal part of right coronary artery demonstrated that while stent struts were embedded in the neointima, but were translucently visible in the proximal segment, stent struts were fully embedded and invisible from middle to distal stented segment (MPG 4736 kb)

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Ishihara, T., Awata, M., Iida, O. et al. Satisfactory arterial repair 1 year after ultrathin strut biodegradable polymer sirolimus-eluting stent implantation: an angioscopic observation. Cardiovasc Interv and Ther 34, 34–39 (2019). https://doi.org/10.1007/s12928-018-0510-4

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  • DOI: https://doi.org/10.1007/s12928-018-0510-4

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