Mario Iannaccone1, Fabrizio D'Ascenzo2, Christian Templin3, Pierluigi Omedè2, Antonio Montefusco2, Giulio Guagliumi4, Patrick W Serruys5, Carlo Di Mario6, Janusz Kochman7, Giorgio Quadri2, Giuseppe Biondi-Zoccai8, Thomas F Lüscher3, Claudio Moretti2, Maurizio D'amico2, Fiorenzo Gaita2, Gregg W Stone9. 1. Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy mario.iannaccone@hotmail.it. 2. Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy. 3. University Heart Center, Cardiology, University Hospital, Zurich, Switzerland. 4. Cardiovascular Department, Ospedali Riuniti di Bergamo, Bergamo, Italy. 5. Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands. 6. National Institute of Health Research Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK. 7. Department of Cardiology, Warsaw Medical University, Warszawa, Poland. 8. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. 9. Division of Cardiology, Columbia University Medical Center, New York, NY, USA.
Abstract
AIMS: The intermediate-term incidence of strut malapposition (SM) and uncovered struts (US), and the degree of neointimal thickness (NIT) according to stent type have not been characterized. METHODS AND RESULTS: All studies of >50 patients in which optical coherence tomography was performed between 6 and 12 months after stent implantation were included. The incidences of SM and US were the co-primary end points, while NIT was the secondary end point. A total of 458 citations were initially appraised at the abstract level, and 11 full-text studies (280 652 analysed struts, 921 patients) were assessed. The 6-12 months incidences of SM and US were 5.0 and 7.8%, respectively, and the mean NIT was 206 μm. Biolimus-eluting stents (BES) and bioresorbable vascular scaffolds (BVS) had the highest SM rates (2.7 and 3.8%, respectively), while everolimus-eluting stents (EES) and fast-release zotarolimus-eluting stents (ZES) had the lowest SM rates (0.9 and 0.1%, respectively). BES and sirolimus-eluting stents (SES) had the highest US rates (7.7 and 8.8%, respectively), while bare metal stents (BMS) and ZES had the lowest US rates (0.3 and 0.3%, respectively). BMS had the greatest NIT (340 μm), while SES, EES, and BES had the least NIT. CONCLUSION: Second-generation drug-eluting stents (DES) have better intermediate-term strut apposition and coverage than first-generation DES, BVS, and BMS. EES demonstrate the overall best combination of healing with suppression of neointimal hyperplasia at 6-12 months. Further studies with clinical correlation are warranted to determine the implications of these findings. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The intermediate-term incidence of strut malapposition (SM) and uncovered struts (US), and the degree of neointimal thickness (NIT) according to stent type have not been characterized. METHODS AND RESULTS: All studies of >50 patients in which optical coherence tomography was performed between 6 and 12 months after stent implantation were included. The incidences of SM and US were the co-primary end points, while NIT was the secondary end point. A total of 458 citations were initially appraised at the abstract level, and 11 full-text studies (280 652 analysed struts, 921 patients) were assessed. The 6-12 months incidences of SM and US were 5.0 and 7.8%, respectively, and the mean NIT was 206 μm. Biolimus-eluting stents (BES) and bioresorbable vascular scaffolds (BVS) had the highest SM rates (2.7 and 3.8%, respectively), while everolimus-eluting stents (EES) and fast-release zotarolimus-eluting stents (ZES) had the lowest SM rates (0.9 and 0.1%, respectively). BES and sirolimus-eluting stents (SES) had the highest US rates (7.7 and 8.8%, respectively), while bare metal stents (BMS) and ZES had the lowest US rates (0.3 and 0.3%, respectively). BMS had the greatest NIT (340 μm), while SES, EES, and BES had the least NIT. CONCLUSION: Second-generation drug-eluting stents (DES) have better intermediate-term strut apposition and coverage than first-generation DES, BVS, and BMS. EES demonstrate the overall best combination of healing with suppression of neointimal hyperplasia at 6-12 months. Further studies with clinical correlation are warranted to determine the implications of these findings. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Anna Franzone; Serge Zaugg; Raffaele Piccolo; Maria Grazia Modena; Ghada W Mikhail; Josepa Mauri Ferré; Ruth Strasser; Liliana Grinfeld; Dik Heg; Peter Jüni; Stephan Windecker; Marie-Claude Morice Journal: PLoS One Date: 2017-08-10 Impact factor: 3.240
Authors: Sylvia Otto; Kristina Nitsche; Christian Jung; Aleh Kryvanos; Andrey Zhylka; Kerstin Heitkamp; Juan-Luis Gutiérrez-Chico; Björn Goebel; P Christian Schulze; Hans R Figulla; Tudor C Poerner Journal: BMC Cardiovasc Disord Date: 2017-04-26 Impact factor: 2.298