European Heart Journal Advance Access originally published online on August 7, 2006
European Heart Journal 2006 27(18):2189-2195; doi:10.1093/eurheartj/ehl181
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Angioscopic differences in neointimal coverage and in persistence of thrombus between sirolimus-eluting stents and bare metal stents after a 6-month implantation
Department of Internal Medicine, Chiba-Hokusoh Hospital, Nippon Medical School 1715 Kamakari, Imba, Chiba 270-1694, Japan
Received 18 February 2006; revised 15 June 2006; accepted 14 July 2006; online publish-ahead-of-print 7 August 2006.
* Corresponding author. Tel: +81 476 99 1111; fax: +81 476 99 1863. E-mail address: mizunok{at}nms.ac.jp
See page 2147 for the editorial comment on this article (doi:10.1093/eurheartj/ehl170)
Aims The neointimal coverage and intracoronary thrombi within stented segments at 6 months after implantation between sirolimus-eluting stents (SESs) and bare metal stents (BMSs) were compared by direct visualization using angioscopy.
Methods and results Forty-six patients (36 stable angina and 10 acute coronary syndrome) were treated with 33 SESs and 33 BMSs. Immediately after and 6 months after stenting, each of the stented segments, edge body, and overlapping segment were observed by angioscopy and the grade of neointimal coverage over the stents was classified as 0: absent neointima, 1: visible struts through thin neointima, or 2: invisible struts. The existence of thrombi was also evaluated. The average grade of the neointimal coverage at 6 months follow-up was lower in the SES than that in the BMS (edge: 1.4±0.7 vs. 1.9±0.2, body: 1.0±0.5 vs. 1.8±0.5, overlapping segment: 0.6±0.7 vs. 1.8±0.5; P<0.0001, P<0.0001, P=0.0069, respectively). The frequency of persistence of thrombus was significantly higher in the SESs than that in the BMSs (86 vs. 29%, respectively; P=0.031).
Conclusion The present study suggested a delayed neointimal stent coverage and slower thrombus disappearance process in the SESs in comparison to the BMSs.
Key Words: Stent • Neointimal hyperplasia • Thrombus
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