Análise comparativa do segmento de "ovelapping" dos stents liberadores de sirolimus e paclitaxel

Abstract

SUMMARY Comparative Analysis of the Overlapping Segment of Sirolimus-versus Paclitaxel-Eluting StentsIntroduction: To treat long complex coronary obstructions, total lesion coverage is recommended. When more than one stent is deployed an overlap segment is mandatory to avoid uncovered gaps between stents. There is no data comparing Sirolimus-(SES) versus Paclitaxel-eluting stents (PES) at overlapping segments in regards to neointimal inhibition or toxic effects on the vessel wall. Objective: To evaluate, by means of serial intravascular ultrasound (IVUS), the efficacy in reducing neointimal proliferation and the vessel changes in the overlapping segment comparing these two drug-eluting stents. Method: Fifty-two patients with 72 de novo coronary lesions were randomized for SES or PES. Fourteen patients in the SES Group and twelve in the PES Group had overlapping segments. Quantitative coronary angiography and IVUS were performed at the time of the procedure and at 8 months follow-up. Results: No significant baseline differences were identified between the 2 groups. The mean stent/lesion ratios were similar (1.74 ± 0.89 for SES vs. 2.01 ± 0.92 for PES; p= 0.47). SES and PES were comparable in reducing neointima hyperplasia in the overlapping zone (neointima volume 2.24 ± 0.9 mm 3 after SES vs. 2.53 ± 1.5 mm 3 after PES; p=0.1 and % neointima obstruction of 18.15 ± 8.5% after SES vs. 26.7 ± 16.8% after PES; p=0.1). There was no positive remodeling in the overlapping segment for both groups (expansion ratio 0.74 ± 0.18 vs. 0.76 ± 0.14, respectively; p=0.74). Other IVUS volumetric measurements were also equivalent between the two cohorts. Conclusion: In our preliminary experience, overlapping of DESs proved

Reação vascular crônica secundária à sobreposição de stents farmacológicos

“…Neste número da Revista Brasileira de Cardiologia Invasiva, Lasave et al 5 mostram uma comparação dos segmentos com sobreposição de PES e SES, usando dados de ultra-sonografia intravascular (IVUS) do estudo randomizado REALITY. As mudanças volumétricas encontradas dentro e fora do stent nos segmentos de sobreposição (volume neointimal, porcentual de obstrução neointimal e razão de expansão do vaso) foram comparáveis entre SES e PES.…”