Tobias Koppara1, Tomohisa Tada2, Erion Xhepa3, Sebastian Kufner3, Robert A Byrne3, Tareq Ibrahim4, Karl-Ludwig Laugwitz5, Adnan Kastrati3, Michael Joner6. 1. Deutsches Herzzentrum, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany; Department of Internal Medicine I - Cardiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 2. Deutsches Herzzentrum, Technische Universität München, Munich, Germany. 3. Deutsches Herzzentrum, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany. 4. Department of Internal Medicine I - Cardiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 5. DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany; Department of Internal Medicine I - Cardiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 6. Deutsches Herzzentrum, Technische Universität München, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner site Munich Heart Alliance, Munich, Germany. Electronic address: michaeljoner@me.com.
Abstract
BACKGROUND: Drug-eluting stents with biodegradable polymer coatings have shown promising outcomes in randomised studies. METHODS: We compared neointimal healing patterns including strut coverage and assessed neointimal maturity using a novel algorithm in coronary lesions treated with sirolimus-eluting stents with biodegradable polymer coating (BP-SES) or everolimus eluting stents with permanent polymer coating (PP-EES) using optical coherence tomography after 6months. RESULTS: A total of 39 patients were randomised to BP-SES (n=19) or PP-EES (n=20) for the treatment of coronary lesions. Of those, 29 patients (14 BP-SES and 15 PP-EES) underwent optical coherence tomography (OCT) and angiography at 6-month follow-up. Tissue coverage and apposition were assessed in a total of 6162 struts (BP-SES, n=2889; PP-EES, n=3273). Neointimal maturity was assessed in 3672 neointimal regions above struts using grey scale intensity analysis. OCT analysis showed neointimal coverage of 2433 (BP-SES) vs. 2702 (PP-EES) struts (84.2% vs. 82.6%, p=0.70), whereas the remainder was uncovered after 6months. Mean neointimal thickness did not differ significantly between groups (54.3±7.8μm vs. 80±14.6μm, p=0.12). The rate of malapposed struts was comparable between groups (1.3% vs. 2.2%, p=0.27). Grey scale signal intensity analysis showed mature tissue coverage of struts in 46.2% in BP-SES vs. 31.8% in PP-EES (p=0.31) of neointimal regions. CONCLUSION: The present study showed comparable early vascular healing response characterised by neointimal coverage with mainly immature neointima in both BP-SES and PP-EES.
RCT Entities:
BACKGROUND: Drug-eluting stents with biodegradable polymer coatings have shown promising outcomes in randomised studies. METHODS: We compared neointimal healing patterns including strut coverage and assessed neointimal maturity using a novel algorithm in coronary lesions treated with sirolimus-eluting stents with biodegradable polymer coating (BP-SES) or everolimus eluting stents with permanent polymer coating (PP-EES) using optical coherence tomography after 6months. RESULTS: A total of 39 patients were randomised to BP-SES (n=19) or PP-EES (n=20) for the treatment of coronary lesions. Of those, 29 patients (14 BP-SES and 15 PP-EES) underwent optical coherence tomography (OCT) and angiography at 6-month follow-up. Tissue coverage and apposition were assessed in a total of 6162 struts (BP-SES, n=2889; PP-EES, n=3273). Neointimal maturity was assessed in 3672 neointimal regions above struts using grey scale intensity analysis. OCT analysis showed neointimal coverage of 2433 (BP-SES) vs. 2702 (PP-EES) struts (84.2% vs. 82.6%, p=0.70), whereas the remainder was uncovered after 6months. Mean neointimal thickness did not differ significantly between groups (54.3±7.8μm vs. 80±14.6μm, p=0.12). The rate of malapposed struts was comparable between groups (1.3% vs. 2.2%, p=0.27). Grey scale signal intensity analysis showed mature tissue coverage of struts in 46.2% in BP-SES vs. 31.8% in PP-EES (p=0.31) of neointimal regions. CONCLUSION: The present study showed comparable early vascular healing response characterised by neointimal coverage with mainly immature neointima in both BP-SES and PP-EES.
Authors: Erion Xhepa; Robert A Byrne; Fernando Rivero; Andi Rroku; Javier Cuesta; Gjin Ndrepepa; Sebastian Kufner; Teresa Bastante Valiente; Salvatore Cassese; Marcos Garcia-Guimaraes; Anna Lena Lahmann; Himanshu Rai; Heribert Schunkert; Michael Joner; María José Pérez-Vizcayno; Nieves Gonzalo; Fernando Alfonso; Adnan Kastrati Journal: Clin Res Cardiol Date: 2019-02-19 Impact factor: 5.460
Authors: Himanshu Rai; Fernando Alfonso; Michael Maeng; Christian Bradaric; Jens Wiebe; Javier Cuesta; Evald Høj Christiansen; Salvatore Cassese; Petra Hoppmann; Roisin Colleran; Fiona Harzer; Jola Bresha; Nejva Nano; Simon Schneider; Karl-Ludwig Laugwitz; Michael Joner; Adnan Kastrati; Robert A Byrne Journal: Int J Cardiovasc Imaging Date: 2021-08-21 Impact factor: 2.357