Difference of neointimal formational pattern and incidence of thrombus formation among 3 kinds of stents: an angioscopic study

JACC Cardiovasc Interv. 2010 Feb;3(2):215-20. doi: 10.1016/j.jcin.2009.10.031.

Abstract

Objectives: The purpose of this study is to compare the neointimal formational pattern and incidence of thrombus formation among sirolimus-eluting (SES), paclitaxel-eluting (PES), and bare-metal stents (BMS) with coronary angioscopy.

Background: Neointimal formation and incidence of mural thrombus are different with the type of stent.

Methods: One hundred successive patients who received 43 SES, 40 PES, or 32 BMS implantation underwent 6-month follow-up coronary angioscopy. We evaluated angioscopic parameters, including minimum and maximum neointimal grade; presence and number of red mural thrombus; neointimal grade around thrombus; and heterogeneity score, which is defined by subtracting minimum from maximum grade within 1 stent by classifying angioscopic neointimal coverage grades into 4 categories. We compared these parameters among 3 kinds of stent groups.

Results: Heterogeneity scores of SES, PES, and BMS were 0.79 +/- 0.60, 1.27 +/- 0.75, and 1.03 +/- 0.82, respectively (p = 0.011). The PES showed the highest incidence of angioscopic red mural thrombus (50% in PES, 12% in SES, and 3% in BMS, p < 0.001), and the number of thrombus observed within 1 stent in the PES group tended to be larger than those in the SES and BMS groups.

Conclusions: At 6 months after stent implantation, PES showed the most heterogeneous neointimal formation and the highest incidence of thrombus formation compared with SES and BMS.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angioscopy*
  • Antineoplastic Agents, Phytogenic / therapeutic use
  • Coronary Angiography
  • Coronary Thrombosis / epidemiology
  • Coronary Thrombosis / etiology*
  • Coronary Thrombosis / pathology
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Paclitaxel / therapeutic use
  • Risk Factors
  • Sirolimus / therapeutic use
  • Stents*
  • Time Factors

Substances

  • Antineoplastic Agents, Phytogenic
  • Immunosuppressive Agents
  • Paclitaxel
  • Sirolimus