Optical coherence tomography evaluation of zotarolimus-eluting stents at 9-month follow-up: comparison with sirolimus-eluting stents.

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Authors: J-S Kim ; I-K Jang ; J-S Kim ; T H Kim ; M Takano ; T Kume ; N W Hur ; Y-G Ko ; D Choi ; M-K Hong ; Y Jang

MeSH: Coronary Stenosis/drug therapy* ; Coronary Stenosis/pathology ; Drug-Eluting Stents* ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/administration & dosage* ; Male ; Middle Aged ; Observer Variation ; Sirolimus/administration & dosage* ; Sirolimus/analogs & derivatives* ; Tomography, Optical Coherence ; Treatment Outcome ; Tunica Intima/pathology

Abstract: OBJECTIVE: To evaluate the vascular response at 9 months after zotarolimus-eluting stent (ZES; Endeavor) implantation using optical coherence tomography (OCT). These findings were compared with those after implantation of a sirolimus-eluting stent (SES; Cypher Select).

DESIGN: Cross-sectional observational study with prospective OCT registry.

SETTING: Nine months after ZES or SES implantation.

PATIENTS AND METHODS: A total of 68 patients (32 ZES and 36 SES) underwent OCT at 9 months after stent implantation. The neointima hyperplasia (NIH) thickness inside each strut and percentage of NIH area at every 1 mm cross section were measured. Main outcome measurement: The degree of neointimal coverage and the prevalence of malapposition at 9 months after ZES and SES implantation using OCT.

RESULTS: The mean (SD) NIH thickness (251.2 (110.0) mum vs 85.5 (53.3) mum, p<0.001) and percentage of NIH area (27.9 (9.1)% vs 11.2 (7.1)%, p<0.001) were significantly greater in ZES than in SES. The prevalence of uncovered strut as well as malapposed strut was significantly lower in ZES than in SES (0.3% vs 12.3%, p<0.001 and 0.08% vs 2.6%, p<0.001). Thrombus was not observed in ZES (0.0% in ZES vs 27.8% in SES, p = 0.001).

CONCLUSIONS: Neointimal coverage in ZES was almost complete and malapposition was very rare at 9-months' follow-up.