Comparison of optical coherence tomographic assessment between first- and second-generation drug-eluting stents
Byeong-Keuk Kim ; Jung-Sun Kim ; Myeong-Ki Hong ; Yangsoo Jang ; Donghoon Choi ; Young-Guk Ko ; Junbeom Park
Yonsei Medical Journal, Vol.53(3) : 524~529, 2012
Yonsei Medical Journal
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.