Comparisons of the effects of stent eccentricity on the neointimal hyperplasia between Sirolimus-eluting stent versus Paclitaxel-eluting stent

Byeong Keuk Kim, Young Guk Ko, Seungjin Oh, Jung Sun Kim, Woong Chol Kang, Dong Woon Jeon, Joo Young Yang, Donghoon Choi, Myeong Ki Hong, Taehoon Ahn, Yangsoo Jang

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Abstract

Purpose: Previous studies suggested that asymmetric stent expansion did not affect suppression of neointimal hyperplasia (NIH) after sirolimus-eluting stents (SES) implantation. The aim of this study was to evaluate the effects of stent eccentricity (SE) on NIH between SES versus paclitaxel-eluting stents (PES) using an intravascular ultrasound (IVUS) analysis from the randomized trial. Materials and Methods: Serial IVUS data were obtained from Post-stent Optimal Expansion (POET) trial, allocated randomly to SES or PES. Three different SE (minimum stent diameter divided by maximum stent diameter) were evaluated; SE at the lesion site with maximal %NIH area (SE-NIH), SE at the minimal stent CSA [SE-minimal stent area (SE-MSA)], and averaged SE through the entire stent (SE-mean). We classified each drug-eluting stents (DES) into the concentric (≥ mean SE) and eccentric groups (< mean SE) based on the mean value of SE. Results: Among 301 enrolled patients, 233 patients [SES (n = 108), PES (n = 125)] underwent a follow-up IVUS. There was no significant correlation between %NIH area and SE-NIH (r = - 0.083, p = 0.391) or SE-MSA (r = - 0.109, p = 0.259) of SES. However, SE-NIH of PES showed a weak but significant correlation with %NIH area (r = 0.269, p < 0.01). As to the associations between SEmean and NIH volume index, SES revealed no significant correlation (r = - 0.001, p = 0.990), but PES showed a weak but significant correlation (r = 0.320, p < 0.01). However, there was no difference in the restenosis rate between the eccentric versus concentric groups of both DES. Conclusion: This study suggests that lower SE of both SES and PES, which means asymmetric stent expansion, may not be associated with increased NIH.

Original languageEnglish
Pages (from-to)823-831
Number of pages9
JournalYonsei medical journal
Volume51
Issue number6
DOIs
Publication statusPublished - 2010 Nov

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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