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Optical coherence evaluation for everolimus-eluting stents at 8 months after implantation (Cooperative Study with Korea)
  1. Takumi Inoue1,
  2. Junya Shite1,
  3. Junghan Yoon2,
  4. Toshiro Shinke1,
  5. Hiromasa Otake1,
  6. Takahiro Sawada1,
  7. Hiroyuki Kawamori1,
  8. Hiroki Katoh1,
  9. Naoki Miyoshi1,
  10. Naoki Yoshino1,
  11. Amane Kozuki1,
  12. Hirotoshi Hariki1,
  13. Ken-ichi Hirata1
  1. 1Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan
  2. 2Yonsei University, Wonju Christian Hospital, South Korea
  1. Correspondence to Associate Professor Junya Shite, Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan; shite{at}med.kobe-u.ac.jp

Abstract

Objective The aim of this study was to evaluate detailed vessel response after everolimus-eluting stents (EES) implantation in human de novo coronary lesions by optical coherence tomography (OCT).

Design, setting and patients Between November 2008 and October 2009, 25 patients (14 men, 65.5±8.6 years) with de novo native coronary artery lesions were implanted with 30 EES, and OCT was performed at 8 months post-implantation.

Main Outcome Measures Neointimal thickness (NIT) on each strut, strut apposition to the vessel wall, the frequency of struts surrounded by low intensity area and the incidence of intra-stent thrombus were analysed. To evaluate the radial unevenness of NIT, the difference between the maximum and minimum NIT (dNT) was calculated for each cross-section.

Results At 236±39 days after implantation, there were no major adverse cardiac events, nor target vessel revascularisation. A total of 5931 struts was evaluated by OCT. The median NIT was 80 μm (25th and 75th percentile 50 μm and 140 μm) and average NIT was 100±74 μm. The number of neointima-covered struts was 5834 (98.4%), and 31 (0.52%) struts showed malapposition without neointimal coverage. The number of struts surrounded by low intensity area was 452 (7.62%). Eleven EES (37%) showed full neointimal coverage. No intra-stent thrombus was detected. The average dNT was 108±77 μm.

Conclusions Most EES struts were covered with uniform and thin neointima. The frequency of low-intensity neointima was very low, which may be a result of promoted vessel healing. These results may support improved clinical outcomes with EES in clinical trials.

  • Coronary angioplasty (PCI)
  • coronary stenting
  • everolimus-eluting stents
  • neointimal coverage
  • optical coherence tomography

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Footnotes

  • Competing interests Wonju Christian Hospital received a research grant from Boston Scientific Corporation, Inc (Natick, Massachusetts, USA).

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Yonsei University, Wonju Christian Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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