Background
The amount of neointimal hyperplasia as well as the percentage of neointimal stent surface coverage may be different among various types of drug-eluting stents (DES).
Methods
From the Stanford University Intravascular Ultrasound (IVUS) Core Laboratory database, this study consisted of the patients enrolled in prospective, multicenter clinical trials with DES deployment for
de novo
coronary lesions and 3-D IVUS at 8- to 9-month follow-up as part of their study protocol. In these cases, 155 single DES: (1) an 18-mm everolimus-eluting (EES, 52 stents in 50 patients); (2) an 18-mm sirolimus-eluting (SES, 51 stents); or (3) a 16-mm paclitaxel-eluting (PES, 52 stents) stent in 153 patients were investigated. Using Simpson’s rule, %neointimal volume was defined as neointimal volume / stent volume × 100. Circumferential stent length covered with neointima (L
N
) and stent perimeter (L
S
) were also measured at every 1-mm cross section throughout the stent. Then, %neointimal coverage was defined as total L
N
/ total L
S ×
100.
Results
EES had comparable %neointimal volume to SES, but less %neointimal volume than PES (5.2±5.3 vs 2.6±4.0 vs 9.2±8.7%,
P<
0.0001), whereas EES had greater %neointimal coverage than SES, but comparable %neointimal coverage to PES (25.7±19.9 vs 9.1±14.6 vs 29.3±23.5%,
P<
0.0001).
Conclusions
Compared to SES, EES had comparable neointimal hyperplasia, but greater neointimal stent coverage by IVUS. Compared to PES, EES had less neointimal hyperplasia, but comparable neointimal stent coverage by IVUS. This unique pattern of neointimal hyperplasia with these platforms may be important to the balance of the short-term efficacy and the long-term safety.
Long-term effects of biodegradable versus durable polymer- coated sirolimus-eluting stents on coronary arterial wall morphology assessed by virtual histology intravascular ultrasound in patients with acute coronary syndrome
