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European Heart Journal Advance Access originally published online on November 29, 2006
European Heart Journal 2007 28(8):961-967; doi:10.1093/eurheartj/ehl413
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Neointimal coverage of sirolimus-eluting stents at 6-month follow-up: evaluated by optical coherence tomography

Daisuke Matsumoto, Junya Shite*, Toshiro Shinke, Hiromasa Otake, Yusuke Tanino, Daisuke Ogasawara, Takahiro Sawada, Oscar Luis Paredes, Ken-ichi Hirata and Mitsuhiro Yokoyama

Department of Internal Medicine, Division of Cardiovascular and Respiratory Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan

Received 6 September 2006; revised 3 October 2006; accepted 9 November 2006; online publish-ahead-of-print 29 November 2006.

* Corresponding author. Tel: +81 78 382 5846; fax: +81 78 382 5859. E-mail address: shite{at}med.kobe-u.ac.jp

See page 918 for the editorial comment on this article (doi:10.1093/eurheartj/ehl554)

Aims: Since the intravascular ultrasound (IVUS) cannot detect neointimal layers in the majority of sirolimus-eluting stents (SES) at the chronic phase, it is still controversial to what extent SES remain uncovered. However, optical coherence tomography (OCT) with excellent resolution may be able to detect thinner neointima.

Methods and results: A total of 34 patients (57 SES) underwent OCT and IVUS evaluations at 6-month follow-up. The thickness of neointima on each SES strut cross-section and strut apposition to the vessel wall was evaluated. By OCT evaluation, the median (25th, 75th percentiles) neointima thickness was 52.5 µm (28.0 µm, 147.6 µm) and the prevalence of struts covered by thin neointima undetectable by IVUS was 64%. The average rate of neointima-covered struts in an individual SES was 89%. Nine SES (16%) showed full coverage by neointima, whereas the remaining stents had partially uncovered strut lesions. Among the 6840 struts visualized by OCT in all of the SES, 79 struts showed malapposition without neointimal coverage, and were frequently observed in the areas of SES overlap.

Conclusion: At 6 months, most of the SES were covered with thin neointima, but few showed full coverage.

Key Words: Sirolimus-eluting stents • Optical coherence tomography • Neointima • Malapposition


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