Arterial repair 4 months after zotarolimus-eluting stent implantation observed on angioscopy

Circ J. 2013;77(5):1186-92. doi: 10.1253/circj.cj-12-1369. Epub 2013 Feb 15.

Abstract

Background: Arterial repair in the early phase following implantation of a zotarolimus-eluting stent (ZES) remains unknown.

Methods and results: Following implantation of 49 Endeavor ZES in 33 patients, follow-up angioscopy was performed in 13 patients (26 ZES) in the early phase (EP; 123±24 days) and in 20 patients (23 ZES) in the middle phase (MP; 247±17 days). Neointimal coverage (NIC) was graded as follows: grade 0, stent struts exposed; grade 1, struts bulging into the lumen, although covered; grade 2, struts were embedded by the neointima but were seen translucently; grade 3, struts fully embedded and invisible. NIC was defined as heterogeneous for NIC grade variation≥1. The presence of thrombus and yellow plaque was also investigated. Although NIC heterogeneity tended to be more frequent in EP than in MP (50% vs. 22%, P=0.070), and yellow plaque significantly more frequent (58% vs. 13%, P=0.0025), the majority of stents were dominant NIC grade 3 at both follow-up periods (73% in EP vs. 78% in MP, P=0.75). There was no significant difference in thrombus (23% in EP vs. 4% in MP, P=0.10) between the follow-ups.

Conclusions: Sufficient arterial repair may have occurred by 4 months after ZES implantation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioscopy*
  • Cardiovascular Agents / administration & dosage*
  • Chi-Square Distribution
  • Coronary Angiography
  • Coronary Thrombosis / etiology
  • Coronary Thrombosis / pathology
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / pathology*
  • Drug-Eluting Stents*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neointima
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Predictive Value of Tests
  • Prosthesis Design
  • Risk Factors
  • Sirolimus / administration & dosage
  • Sirolimus / analogs & derivatives*
  • Time Factors
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • zotarolimus
  • Sirolimus