"Head-to-head comparison between sirolimus-eluting and paclitaxel-eluting stents in patients with complex coronary artery disease: an intravascular ultrasound study"

Catheter Cardiovasc Interv. 2006 Jun;67(6):846-51. doi: 10.1002/ccd.20755.

Abstract

Background: The aim of this study was to assess neointimal hyperplasia following sirolimus-eluting (SES) and paclitaxel-eluting stents (PES) implantation in a patients with complex coronary disease.

Method: Between January to December 2004, 70 patients were enrolled in this study (SES = 37; PES = 33. The primary objective was to assess the efficacy of SES and PES on neointimal proliferation inhibition in patients with complex coronary lesions by volumetric 3D intravascular ultrasound (IVUS) assessment at six-month follow-up.

Results: Baseline clinical, demographic or angiographic characteristics were well balanced in both groups. All procedures as well as hospitalisation were uneventful. The percentage of B2/C lesions in our study was > 90% in both groups. The IVUS-assessed in-stent mean neointimal hyperplasia volume was significantly lower in lesions treated with SES compared to PES (4.1 +/- 11 mm3 vs. 17.4 +/- 23 mm3, p < 0.002) at 6 month follow-up. No difference in both MACE (3.0 versus 6.0%, p = NS) and restenosis (5.4 versus 9.1%, p = NS) were found. The in-segment late loss at six month was 0.26 mm in the SES and 0.48 mm in the PES group (p = NS).

Conclusions: The present study showed reduced neointimal proliferation after sirolimuseluting as compared to paclitaxel-eluting stents in patients with complex coronary artery disease. Both SES and PES were associated with low rate of angiographic restenosis or major adverse cardiovascular events.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Angioplasty, Balloon, Coronary*
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / drug therapy*
  • Coronary Artery Disease / therapy
  • Drug Delivery Systems*
  • Female
  • Humans
  • Hyperplasia
  • Male
  • Middle Aged
  • Paclitaxel / administration & dosage*
  • Paclitaxel / therapeutic use
  • Prospective Studies
  • Sirolimus / administration & dosage*
  • Sirolimus / therapeutic use
  • Stents*
  • Treatment Outcome
  • Tunica Intima / diagnostic imaging
  • Tunica Intima / drug effects*
  • Ultrasonography, Interventional
  • Vascular Patency

Substances

  • Paclitaxel
  • Sirolimus