Abstract

Background

Orsiro ultrathin-strut bioresorbable-polymer sirolimus-eluting stent (BP-SES) might facilitate early vascular healing responses that seems to be associated with improved long-term clinical outcomes. We compared the early vascular healing responses to BP-SES and Xience durable-polymer everolimus-eluting stent (DP-EES) in patients with chronic coronary syndrome (CCS) using optical coherence tomography (OCT).

Methods

A total of 40 patients with CCS receiving OCT-guided PCI were included. 20 patients were assigned to BP-SES, and 20 to DP-EES. OCT was performed immediately after stent placement (post-procedure) and at 1 month follow-up. Struts were recorded as uncovered if any part was visibly exposed in the lumen or covered if a layer of tissue covered all reflecting surfaces. The incidence of intrastent thrombus (IS-Th) and irregular protrusion (IRP) were also assessed.

Results

At 1 month, the percentage of uncovered struts was significantly lower in the BP-SES compared with the DP-EES (2.8±1.6% vs. 5.8±1.8%, respectively; p<0.001), and that of malapposed struts was similar between both groups (2.5±3.1% vs. 2.4±2.2%; p=0.76). There were no differences in the incidence of IS-Th (65.0% vs. 55.0% at post-procedure; p=0.54, 30.0% vs. 35.0% at 1 month; p=0.75) and IRP (30.0% vs. 25.0% at post-procedure; p=0.74). IRP had completely resolved at 1 month in both groups.

Conclusion

Early vascular healing response to Orsiro BP-SES implantation was revealed in CCS patients at 1 month compared with Xience DP-EES. Orsiro BP-SES may have a potential to shorten the dual antiplatelet therapy duration.

Post-procedure1-month
BP-SES (n=20)DP-EES (n=20)P-valueBP-SES (n=20)DP-EES (n=20)P-value
Struts analyzed (n)306±72264±900.09303±75258±920.07
Stent area (mm2)6.4±1.86.7±1.80.596.7±2.16.7±1.90.98
Lumen area (mm2)6.4±1.86.7±1.70.596.5±2.16.5±1.90.96
% Uncovered strut (%)78.8±10.680.5±13.70.362.8±1.65.8±1.8<0.001
% Malapposed strut (%)7.1±5.32.9±2.60.0042.5±3.12.4±2.20.76
Incidence of IS-Th (n (%))13 (65.0%)11 (55.0%)0.546 (30.0%)7 (35.0%)0.75
Incidence of IRP (n (%))6 (30.0%)5 (25.0%)0.740 (0%)0 (0%)
Post-procedure1-month
BP-SES (n=20)DP-EES (n=20)P-valueBP-SES (n=20)DP-EES (n=20)P-value
Struts analyzed (n)306±72264±900.09303±75258±920.07
Stent area (mm2)6.4±1.86.7±1.80.596.7±2.16.7±1.90.98
Lumen area (mm2)6.4±1.86.7±1.70.596.5±2.16.5±1.90.96
% Uncovered strut (%)78.8±10.680.5±13.70.362.8±1.65.8±1.8<0.001
% Malapposed strut (%)7.1±5.32.9±2.60.0042.5±3.12.4±2.20.76
Incidence of IS-Th (n (%))13 (65.0%)11 (55.0%)0.546 (30.0%)7 (35.0%)0.75
Incidence of IRP (n (%))6 (30.0%)5 (25.0%)0.740 (0%)0 (0%)
Funding Acknowledgement

Type of funding source: None

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