Comparison of neointimal hyperplasia and peri-stent vascular remodeling after implantation of everolimus-eluting versus sirolimus-eluting stents: Intravascular ultrasound results from the EXCELLENT study

Young Guk Ko, Dong Ho Shin, Jung Sun Kim, Byeong Keuk Kim, Donghoon Choi, Myeong Ki Hong, Hyeon Cheol Gwon, Taehoon Ahn, In Ho Chae, Jung Han Yoon, Hyo Soo Kim, Yangsoo Jang

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3 Citations (Scopus)

Abstract

This study was designed to compare neointimal hyperplasia and peri-stent arterial remodeling after implantation of everolimus-eluting stent (EES) versus sirolimuseluting stent (SES) using intravascular ultrasound (IVUS). The study population was a subgroup of 278 patients from the EXCELLENT trial, a randomized study comparing EES to SES in de novo coronary artery lesions (total n = 1,443, 3:1 randomization) who underwent post-PCI and 9-month follow-up IVUS evaluation. There were 209 patients in the EES group and 69 in the SES group. Baseline clinical and angiographic characteristics were similar between the two groups except for age and target lesion locations.At 9 months, percent neointimal volume obstruction did not differ between EES and SES (2.6 ± 4.0 % vs. 2.5 ± 4.8 %, p = 0.814). However, the relative change in the vessel (4.3 ± 13.7 % vs. 8.8 ± 18.6 %, p = 0.030) and plaque volume index (4.2 ± 17.4 % vs. 10.5 ± 22.3 %, p = 0.016) of the stented segment frompost-intervention to follow-upwas significantly less with EES than with SES. In addition, positive peri-stent vascular remodeling defined as an increase in vessel volume index[10 % (27.8 vs. 42.0 %, p = 0.027) and late acquired stent malapposition (LASM, 1.9 vs. 15.9 %, p<0.001) were observed less frequently with EES than SES. EES and SES were similarly effective in reducing neointimal hyperplasia. However, positive peri-stent vascular remodeling and LASM occurred less frequently with EES than SES.

Original languageEnglish
Pages (from-to)1229-1236
Number of pages8
JournalInternational Journal of Cardiovascular Imaging
Volume29
Issue number6
DOIs
Publication statusPublished - 2013 Aug

Bibliographical note

Funding Information:
Acknowledgments This study was partly supported by a grant from the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (No. A085012, A102064, and A110879); a grant from the Korea Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (No. A085136); and the Cardiovascular Research Center, Seoul, Korea.

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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