Difference of vascular healing between bioabsorbable-polymer and durable-polymer new generation drug-eluting stents: an optical coherence tomographic analysis

Matsuhiro, Yutaka; Nakamura, Daisuke; Shutta, Ryu; Kawamura, Akito; Nakamura, Hitoshi; Okamoto, Naotaka; Matsunaga‐Lee, Yasuharu; Yano, Masamichi; Egami, Yasuyuki; Sakata, Yasushi; Nishino, Masami; Tanouchi, Jun

doi:10.1007/s10554-020-02094-y

Cited by 6 publications

(10 citation statements)

References 35 publications

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“…There are several reports comparing vessel healing after stent implantation between different coronary stents, 5,11) but the stents have many differences including not only the number of connectors but strut thickness, stent material, shape of hoops, drugs, and polymers. The present study is the first attempt to show the effect of only the number of connectors on mid-term vessel healing and stent expansion using unique design of Promus PREMIER stents.…”

Section: Discussionmentioning

confidence: 99%

Effects of Number of Stent Connectors on Mid-Term Vessel Healing and Stent Expansion Assessed by Optical Coherence Tomography

et al. 2021

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Objective: Coronary stents generally consist of hoops and connectors. The number of connectors has been associated with longitudinal strength, flexibility, and deliverability of stents. However, a mid-term impact of number of connectors after stent implantation has been unclear. We sought to examine the effect of number of connectors on vessel healing and stent expansion using optical coherence tomography (OCT). Materials and Methods:The study included 39 patients with 46 Promus PREMIER stents who underwent OCT examination at 8 months after stent deployment. Promus PREMIER stents have 4 or 5 connectors in a proximal few-millimeter segment of the stents and 2 connectors in the entire stents except the proximal few millimeters. We analyzed OCT cross-sectional images in the proximal 4-or 5-connector segments and adjacent 2-connector segments at 1-mm intervals. OCT parameters including stent apposition, neointimal coverage, the presence of peri-strut low-intensity area (PLIA), stent area, maximal and minimum stent diameters, and stent eccentricity index were compared between the 2 segments. Results: The 4-or 5-connector segments had a significantly higher proportion of well-apposed struts without neointima (5.8% [interquartile range (IQR): 0-21.9%]) compared to the 2-connector segments (0% [IQR: 0-91.3%], p = 0.007). The proportion of struts with PLIA was higher in the 4-or 5-connector segments (7.1% [IQR: 0-32.0%]) than in the 2-connector segments (0% [IQR: 0-14.6%], p = 0.026). Stent area, maximal and minimum stent diameters, and stent eccentricity index were comparable between the 2 segments. Conclusion:The number of connectors were associated with vessel healing processes including neointimal coverage and the presence of PLIA but did not restrict stent expansion.

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Section: Discussionmentioning

confidence: 99%

Effects of Number of Stent Connectors on Mid-Term Vessel Healing and Stent Expansion Assessed by Optical Coherence Tomography

et al. 2021

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“…To measure inter-observer reproducibility, the percentage of uncovered struts and the percentage of malapposed struts were compared using the Bland-Altman method in 10 randomly selected OCT image. [17]…”

Section: Oct Image Analysismentioning

confidence: 99%

Better vascular healing of ultrathin strut biodegradable-polymer sirolimus-eluting stents in patients with acute coronary syndrome

Kawamura¹,

Egami²,

Kawanami³

et al. 2021

Preprint

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This study aimed to compare the strut coverage between Orsiro ultrathin struts biodegradable polymer sirolimus-eluting stents (O-SES) and Xience thin struts durable polymer everolimus-eluting stents (X-EES) in acute coronary syndrome (ACS) patients using optical coherence tomography (OCT). In BIOSTEMI trial, O-SESs were superior to X-EESs with respect to target lesion failure (TLF) in ACS patients. However, there were few reports comparing intravascular imaging between the two stents in ACS. Between August 2016 and February 2020, 50 lesions from 50 ACS patients who underwent OCT-guided percutaneous coronary intervention (PCI) were enrolled. We compared mid-term vascular healing using OCT between O-SESs and X-EESs at 8-month after stenting. The protocol was approved by the Osaka Rosai Hospiral ethics committee. Among 50 lesions, the X-EES group consisted of 25 lesions and the O-SES of 25 lesions. The percentage of covered strut, the percentage of malapposed strut and mean neointimal thickness at 8-month were evaluated. In the 8-month OCT analysis, the proportion of covered strut was significantly higher in the O-SES group than in in the X-EES group (97.3% vs. 86.0%; p = 0.001). On the other hand, there were no significant differences in the frequency of malapposed strut (0.4% vs 1.0%, p = 0.238). The O-SES group had the tendency of thinner neointima compared to the X-EES group (60µm vs 76µm, p = 0.089). Compared to X-EESs, O-SESs showed better mid-term vascular healing and tended to have thinner neointima in ACS patients. Ultra-thin strut may play a key role in better vascular healing.

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“…We previously published the details of the OCT analysis. [7,8] All variables were analyzed at lesion level. In brief, the cross-sectional OCT images were analyzed at 1-mm intervals within the entire target segment of the pre-procedural, post-procedural, and 3-month follow-up OCT data.…”

Section: Oct Image Analysismentioning

confidence: 99%

“…The inter-observer reproducibility of the OCT image analysis in our institution were shown in a previous article. [7] Statistical Analysis No sample size calculation was performed due to the absence of previous data. Categorical variables are stated as numbers (percentages) and compared using a Pearson's chi-squared test.…”

Section: Oct Image Analysismentioning

confidence: 99%

“…Actually, several OCT studies have demonstrated that bioabsorbable polymer coating have an earlier vascular healing than durable polymer coating. [7,16] As a hypothesis, polymer-free stents can be free from polymer-related in ammation just after stent implantation and may promote earlier re-endothelialization than bioabsorbable polymer DESs. In summary, both ultra-thin strut and non-polymer coating can achieve early vascular healing.…”

Section: Early Vascular Healing Of Upf-sesmentioning

confidence: 99%

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Early vascular healing of ultra-thin strut polymer-free sirolimus-eluting stents in acute coronary syndrome: USUI-ACS study

Matsuhiro

Egami

Okamoto

et al. 2021

Preprint

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Purpose:Ultra-thin strut polymer-free sirolimus eluting stent (UPF-SES) have two novel characteristics, ultra-thin strut and polymer-free coating, which have the potential to achieve early re-endotherialization. However, a little is known whether early vascular healing of UPF-SES can be achieved in patients with acute coronary syndrome (ACS).The aim of this study was to evaluate the vascular healing after an implantation of UPF-SES in patients with ACS using optical coherence tomography (OCT) at 3 months after the stent implantation. Methods:From September 2020 and January 2021, a total of 31 consecutive patients presenting with ACS who underwent OCT examinations at the initial percutaneous coronary intervention (PCI) and 3-month follow-up were enrolled in the USUI-ACS study. The endpoints of this study were neointimal strut coverage, malapposition, and mean neointimal hyperplasia (NIH) thickness at 3-month follow-up.Results:Over a mean follow-up of 91 days after the initial PCI, the follow-up OCT was examined. The median percentage of covered struts was 98.4% and malapposed struts 0%, and the mean NIH thickness was 60μm.Conclusions:UPF-SES exhibited an excellent early vascular healing at 3-months in patients with ACS.

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Difference of vascular healing between bioabsorbable-polymer and durable-polymer new generation drug-eluting stents: an optical coherence tomographic analysis

Cited by 6 publications

References 35 publications

Effects of Number of Stent Connectors on Mid-Term Vessel Healing and Stent Expansion Assessed by Optical Coherence Tomography

Effects of Number of Stent Connectors on Mid-Term Vessel Healing and Stent Expansion Assessed by Optical Coherence Tomography

Better vascular healing of ultrathin strut biodegradable-polymer sirolimus-eluting stents in patients with acute coronary syndrome

Early vascular healing of ultra-thin strut polymer-free sirolimus-eluting stents in acute coronary syndrome: USUI-ACS study

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