European Heart Journal Advance Access originally published online on July 5, 2006
European Heart Journal 2006 27(15):1811-1817; doi:10.1093/eurheartj/ehl134
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Evaluation of the haemodynamic characteristics of drug-eluting stents at implantation and at follow-up
1 Department of Cardiology, Catharina Hospital, PO Box 1350, 5602 ZA Eindhoven, The Netherlands
2 Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
Received 28 September 2005; revised 15 May 2006; accepted 15 June 2006; online publish-ahead-of-print 5 July 2006.
* Corresponding author. Tel: +31 40 239 7004; fax: +31 40 244 7885. E-mail address: nico.pijls{at}inter.nl.net
See page 1764 for the editorial comment on this article (doi:10.1093/eurheartj/ehi863)
Aims The aim of this study was to investigate the physiologic parameters: fractional flow reserve (FFR), hyperaemic trans-stent gradient (HTG), and wall shear stress (WSS) at implantation and at 6-month follow-up in the drug-eluting sirolimus stent and in its bare metal counterpart implanted in pairs within the same patient.
Methods and results Twenty patients, accepted for percutaneous coronary intervention of at least two coronary arteries with comparable vessel and stenosis characteristics, received at random one sirolimus-eluting stent and one bare metal stent (BMS). Coronary pressure, FFR, HTG, and WSS were measured just after stent implantation and at 6-month follow-up. At 6-month follow-up, FFR was significantly higher in the sirolimus group compared with the bare metal group (0.91±0.05 vs. 0.83±0.10, P=0.027) and HTG was significantly lower (1.2±1.2 vs. 7.5±8.1 mmHg, P<0.001). In-stent WSS at 6 months remained normal in the sirolimus group but was elevated in the bare metal group (1.6±0.7 vs 3.9±3.1 Pa, respectively, P=0.003).
Conclusion The physiologic characteristics of the drug-eluting sirolimus stents were superior to those of the equivalent BMS. Six months after implantation, FFR was significantly higher, HTG was significantly lower in arteries treated by a sirolimus stent, and normal WSS was maintained within the drug-eluting stent.
Key Words: Fractional flow reserve • Blood flow • Angioplasty • Coronary disease
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