Daisuke Terashita1, Hiromasa Otake1, Toshiro Shinke2, Yoshinobu Murasato3, Yoshihisa Kinoshita4, Masahiro Yamawaki5, Yoshihiro Takeda6, Kenichi Fujii7, Shin-Ichiro Yamada8, Yoshihisa Shimada9, Takehiro Yamashita10, Kazuhiko Yumoto11, Ken-Ichi Hirata1. 1. Department of Cardiovascular Medicine, Kobe University, Kobe, Japan. 2. Department of Cardiovascular Medicine, Kobe University, Kobe, Japan. Electronic address: shinke@med.kobe-u.ac.jp. 3. Clinical Research Institute, Kyushu Medical Center, Fukuoka, Japan; Department of Cardiology, Cardiovascular Center, Kyushu Medical Center, Fukuoka, Japan; Department of Cardiovascular Medicine, New Yukuhashi Hospital, Yukuhashi, Japan. 4. Department of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan. 5. Department of Cardiovascular Medicine, Saiseikai Yokohama-Eastern Hospital, Yokohama, Japan. 6. Department of Cardiovascular Medicine, Rinku General Medical Center, Izumi-Sano, Japan. 7. Department of Cardiovascular Medicine, Hyogo Medical University, Nishinomiya, Japan. 8. Department of Cardiovascular Medicine, Himeji Cardiovascular Center, Himeji, Japan. 9. Department of Cardiovascular Medicine, Shiroyama Hospital, Habikino, Japan. 10. Department of Cardiovascular Medicine, Cardiovascular Center Hokkaido Ono Hospital, Sapporo, Japan. 11. Department of Cardiovascular Medicine, Yokohama Rosai Hospital, Yokohama, Japan.
Abstract
BACKGROUND: We aimed to clarify the differences in vessel healing after stenting of bifurcation lesions using sirolimus-eluting stents (SESs) or everolimus-eluting stents (EESs). METHODS: Japanese Registry Study in Comparison Between Everolimus-Eluting Stent and Sirolimus-Eluting Stent for the Bifurcation Lesion (J-REVERSE) is a prospective multicentre registry of 303 bifurcation lesions that were treated with provisional SES or EES with or without final kissing inflation. The first 115 lesions at selected study sites were predefined for inclusion in the optical coherence tomography (OCT) substudy, and 9-month follow-up OCT was conducted in 64 lesions (SES, n = 18; EES, n = 46). In addition to standard OCT parameters, stent eccentricity index (SEI; minimum divided by the maximum stent diameter), neointimal unevenness score (NUS; maximum neointimal thickness in the cross-section [CS] divided by the average neointimal thickness [NIT] of the same CS; uniformity of the neointima suppression) were averaged for each segment (proximal, bifurcation, and distal segments). RESULTS: Overall, the average stent and luminal area, NIT, and frequency of uncovered struts were similar. The frequency of malapposed struts and SEI were significantly lower in the EES group than in the SES group. The EES group had a significantly smaller NUS in the proximal and distal segments. CONCLUSIONS: EESs offer homogeneous vessel healing with less malapposition in the treatment of bifurcation lesions.
BACKGROUND: We aimed to clarify the differences in vessel healing after stenting of bifurcation lesions using sirolimus-eluting stents (SESs) or everolimus-eluting stents (EESs). METHODS: Japanese Registry Study in Comparison Between Everolimus-Eluting Stent and Sirolimus-Eluting Stent for the Bifurcation Lesion (J-REVERSE) is a prospective multicentre registry of 303 bifurcation lesions that were treated with provisional SES or EES with or without final kissing inflation. The first 115 lesions at selected study sites were predefined for inclusion in the optical coherence tomography (OCT) substudy, and 9-month follow-up OCT was conducted in 64 lesions (SES, n = 18; EES, n = 46). In addition to standard OCT parameters, stent eccentricity index (SEI; minimum divided by the maximum stent diameter), neointimal unevenness score (NUS; maximum neointimal thickness in the cross-section [CS] divided by the average neointimal thickness [NIT] of the same CS; uniformity of the neointima suppression) were averaged for each segment (proximal, bifurcation, and distal segments). RESULTS: Overall, the average stent and luminal area, NIT, and frequency of uncovered struts were similar. The frequency of malapposed struts and SEI were significantly lower in the EES group than in the SES group. The EES group had a significantly smaller NUS in the proximal and distal segments. CONCLUSIONS: EESs offer homogeneous vessel healing with less malapposition in the treatment of bifurcation lesions.
Authors: Hendrik Wienemann; Felix Meincke; Marius Vach; Christian-Hendrik Heeger; Annika Meyer; Tobias Spangenberg; Karl Heinz Kuck; Alexander Ghanem Journal: Herz Date: 2022-04-09 Impact factor: 1.443
Authors: Indulis Kumsars; Niels Ramsing Holm; Matti Niemelä; Andrejs Erglis; Kari Kervinen; Evald Høj Christiansen; Michael Maeng; Andis Dombrovskis; Vytautas Abraitis; Aleksandras Kibarskis; Thor Trovik; Gustavs Latkovskis; Dace Sondore; Inga Narbute; Christian Juhl Terkelsen; Markku Eskola; Hannu Romppanen; Mika Laine; Lisette Okkels Jensen; Mikko Pietila; Pål Gunnes; Lasse Hebsgaard; Ole Frobert; Fredrik Calais; Juha Hartikainen; Jens Aarøe; Jan Ravkilde; Thomas Engstrøm; Terje K Steigen; Leif Thuesen; Jens F Lassen Journal: Open Heart Date: 2020-01-19