Yonsei Med J.  2012 May;53(3):524-529. 10.3349/ymj.2012.53.3.524.

Comparison of Optical Coherence Tomographic Assessment between First- and Second-Generation Drug-Eluting Stents

• Kim BK
• Kim JS
• Park J
• Ko YG
• Choi D
• Jang Y
• Hong MK

• KMID: 1776986
• DOI: http://doi.org/10.3349/ymj.2012.53.3.524

Abstract

PURPOSE
There is a lack of sufficient data in comparison of optical coherence tomographic (OCT) findings between first- and second-generation drug-eluting stents (DES). Compared to first-generation (i.e., sirolimus- or paclitaxel-eluting stents), second-generation DESs (i.e., everolimus- or biolinx-based zotarolimus-eluting stents) might have more favorable neointimal coverage.
MATERIALS AND METHODS
Follow-up OCT findings of 103 patients (119 lesions) treated with second-generation DESs were compared with those of 139 patients (149 lesions) treated with first-generation DESs. The percentage of uncovered or malapposed struts, calculated as the ratio of uncovered or malapposed struts to total struts in all OCT cross-sections, respectively, was compared between the two groups.
RESULTS
Both DES groups showed similar suppression of neointimal hyperplasia (NIH) on OCT (mean NIH cross-sectional area; second- vs. first-generation=1.1+/-0.5 versus 1.2+/-1.0 mm2, respectively, p=0.547). However, the percentage of uncovered struts of second-generation DESs was significantly smaller than that of first-generation DESs (3.8+/-4.8% vs.7.5+/-11.1%, respectively, p<0.001). The percentage of malapposed struts was also significantly smaller in second-generation DESs than in first-generation DESs (0.4+/-1.6% vs.1.4+/-3.7%, respectively, p=0.005). In addition, intra-stent thrombi were less frequently detected in second-generations DESs than in first-generation DESs (8% vs. 20%, respectively, p=0.004).
CONCLUSION
This follow-up OCT study showed that second-generation DESs characteristically had greater neointimal coverage than first-generation DESs.

Keyword

Optical coherence tomography; stent

MeSH Terms

Aged
Coronary Angiography
*Drug-Eluting Stents
Female
Humans
Male
Middle Aged
Neointima/pathology/prevention & control
Tomography, Optical Coherence/*methods

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