Angioscopic differences in neointimal coverage and in persistence of thrombus between sirolimus-eluting stents and bare metal stents after a 6-month implantation

Eur Heart J. 2006 Sep;27(18):2189-95. doi: 10.1093/eurheartj/ehl181. Epub 2006 Aug 7.

Abstract

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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angina Pectoris / therapy
  • Coronary Angiography
  • Coronary Thrombosis / pathology
  • Coronary Thrombosis / therapy*
  • Coronary Vessels / pathology*
  • Drug Implants
  • Female
  • Follow-Up Studies
  • Humans
  • Hyperplasia / pathology
  • Immunosuppressive Agents / administration & dosage*
  • Male
  • Middle Aged
  • Observer Variation
  • Recurrence
  • Sirolimus / administration & dosage*
  • Stents*
  • Tunica Intima / pathology*

Substances

  • Drug Implants
  • Immunosuppressive Agents
  • Sirolimus