Korean Circ J.  2004 May;34(5):477-484. 10.4070/kcj.2004.34.5.477.

The Effects of a Carbon Ion Implantation Technique on In-stent Restenosis: Korean Multicentered Randomized Trial

Affiliations
  • 1Ajou University Medical Center, Korea.
  • 2Keimyong University Dongsan Medical Center, Korea.
  • 3Inje University Sanggye Paik Hospital, Korea.
  • 4Chung-Ang University Yongsan Hospital, Korea.
  • 5The Catholic University of Korea, 6Inha University Hospital, Korea.
  • 6Chungnam National University Hospital, Korea.
  • 7National Health Insurance Corporation Ilsan Hospital, Korea.
  • 8Yonsei University Wonju Christian Hospital, Korea.
  • 9Sungkyunkwan University Samsung Medical Center, Korea.
  • 10Yonsei Cardiovascular Center, Korea.
  • 11Chonnam National University Hospital, Korea.
  • 12Asan Kangnung Hospital, Korea.
  • 13Carbon Implanted ARTHOSInert Stent Study Group, Korea.

Abstract

BACKGROUND AND OBJECTIVES
Heavy metal ions released from a stainless steel stent can induce an inflammatory reaction that might be associated with in-stent restenosis. A carbon ion implantation technique, which physically integrates carbon ions into the surface of the stainless steel lattice, can block heavy metal ion diffusion, and improve the biocompatibility. This study was designed to evaluate the efficacy of a carbon ion implanted Arthosinert stent on the reduction of in-stent restenosis and the improvement in the clinical outcomes.
SUBJECTS AND METHODS
193 de novo coronary lesions in 191 anginal patients at 14 centers, with reference diameters from 2.75 to 4.5 mm, were randomly assigned to either an Arthosinert (100 patients, 102 lesions) or an Arthos (91 patients, 91 lesions) stent. The lesion length was 14.1+/-5.7 mm. The ACC/AHA (American College of Cardiology/American Heart Association) lesion classifications were A:15.0%, B1:36.8%, B2:35.8% and C:12.4%. The study end points are angiographic restenosis, during a six-month follow-up, and Major adverse cardiac event. In-stent restenosis was defined as a diameter of stenosis > or =50%.
RESULTS
A six-month angiographic follow-up was obtained for 72.3% (138/191) of the subjects. There were no significant differences between the Arthosinert and Arthos groups in the rates of restenosis (17.8% vs. 31.8%, p=0.055) and Target vessel revascularization (7.0% vs. 11.0%, p=0.476). There were no deaths or non-fatal myocardial infarction in either group.
CONCLUSION
The treatment of de novo coronary stenosis, with carbon ion implanted stents, showed a tendency for lower six-month angiographic restenosis rates than the conventional 316L stainless steel stents. A larger trial will be needed to confirm the efficacy of the carbon ion implanted stent.

Keyword

Carbon; Stents; Coronary restenosis

MeSH Terms

Carbon*
Classification
Constriction, Pathologic
Coronary Restenosis
Coronary Stenosis
Diffusion
Follow-Up Studies
Heart
Humans
Ions
Myocardial Infarction
Stainless Steel
Stents
Carbon
Ions
Stainless Steel
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