Optical Coherence Tomographic Comparison of Neointimal Coverage Between Sirolimus-and Resolute Zotarolimus-Eluting Stents at 9 Months After Stent Implantation

OBJECTIVES: The Resolute zotarolimus-eluting stent (ZES-R) has a thinner stent strut with biocompatible polymer than first generation drug-eluting stents. However, minimal optical coherencetomography (OCT) data exists about vascular responses after ZES-R implantation.

METHODS: This study investigated OCT findings in ZES-R implantation and compared them to those in sirolimus-eluting stent (SES) implantation. A total of 123 lesions (43 ZES-R and 80 SES) in 111 patients were evaluated with OCT at 9 months after stent implantation. Strut apposition, neointimalhyperplasia (NIH) thickness, and stent coverage on each stent strut were evaluated.

RESULTS: Mean NIH thickness was significantly greater in ZES-R-treated lesions than in SES-treated lesions (166 ± 73 μm vs. 96 ± 63 μm, respectively, P < 0.001). The percentage of uncovered strut was significantly lower in ZES-R-treated lesions than in SES-treated lesions (4.4 ± 4.8% vs. 10.3 ± 13.2%, respectively, P = 0.05). The percentage of malapposed struts was also significantly lower in ZES-R-treated than in SES-treated lesions (0.1 ± 0.4% vs. 1.5 ± 4.2%, respectively, P = 0.002). Intracoronary thrombus was less frequently detected in ZES-R-treated lesions (4.7% vs. 30.0%, respectively, P = 0.001).

CONCLUSIONS: ZES-R showed a lower incidence of uncovered or malapposed stent struts and intracoronary thrombus than SES at 9-month follow-up OCT examination. Compared with SES, ZES-R may elicit more favorable vascular responses at the expense of an increased neointimal proliferation. 

PMID: 2185865

Posted in Invasive Imaging and tagged , , , , .

One Comment

  1. See post August 2nd:

    Optical coherence tomography: has its time come?
    Lindsay AC, Viceconte N, Di Mario C.
    Heart. 2011 Sep;97(17):1361-2.

Leave a Reply

Your email address will not be published. Required fields are marked *