Korean J Intern Med.  2009 Dec;24(4):323-329. 10.3904/kjim.2009.24.4.323.

Comparison of Sirolimus and Paclitaxel-Eluting Stents for Complex Coronary Lesions: An Intravascular Ultrasound Study

• Cho YK
• Hur SH
• Kim HT
• Kim IC
• Park HS
• Yoon HJ
• Nam CW
• Kim H
• Han SW
• Kim YN
• Kim KB

• KMID: 1776660
• DOI: http://doi.org/10.3904/kjim.2009.24.4.323

Abstract

BACKGROUND/AIMS
Recent intravascular ultrasound (IVUS) studies of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) have demonstrated a significant reduction in neointimal hyperplasia (NIH) based on simple coronary lesions. In this study, we evaluated the efficacy of SES and PES using IVUS in complex coronary lesions. METHODS: Eighty-seven patients in whom 95 drug-eluting stents (66 SES and 29 PES) were implanted in complex coronary lesions were enrolled in this study. Case selection was based on the availability of IVUS and quantitative coronary angiographic (QCA) examinations at the index procedure and at follow-up. The neointimal volume index (volume/length: NIVI) and percent neointimal volume (% NIV) were calculated. The longitudinal length of stented segments without IVUS-detectable NIH was also evaluated. RESULTS: The baseline patient demographics were similar between the SES and PES groups. At follow-up, no significant differences were observed in the vessel, plaque, or stent volume indices between the two groups. However, the NIVI and % NIV were significantly lower in the SES group (p<0.01). The longitudinal length of stented segments without IVUS-detectable NIH was significantly higher in the SES group (p<0.01). The net gain was significantly larger in the SES group (2.3+/-0.7 vs. 2.0x0.6 mm, p=0.025), while the rate of major adverse cardiac events was similar between the two groups. CONCLUSIONS: Although SES showed significantly greater suppression of NIH at follow-up, both stents were highly effective at inhibiting NIH in complex coronary lesions.

Keyword

Coronary artery disease; Drug-eluting stents; Ultrasonography

MeSH Terms

Adult
Aged
Coronary Angiography
Coronary Artery Disease/radiography/*therapy/ultrasonography
*Drug-Eluting Stents/adverse effects
Female
Follow-Up Studies
Humans
Hyperplasia
Male
Middle Aged
Paclitaxel/*administration & dosage
Sirolimus/*administration & dosage
Tunica Intima/pathology
Ultrasonography, Interventional/*methods