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K Ogura, H Tsujita, T Arai, R Sakai, H Tanaka, R Masaki, Y Oishi, K Nomura, K Arai, T Sekimoto, S Kondo, S Tsukamoto, H Mori, H Matsumoto, T Shinke, Early vascular healing following bioresorbable-polymer sirolimus-eluting stent implantation in comparison with durable-polymer everolimus-eluting stent: sequential optical coherence tomography study, European Heart Journal, Volume 41, Issue Supplement_2, November 2020, ehaa946.1391, https://doi.org/10.1093/ehjci/ehaa946.1391
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Abstract
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).
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.
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.
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-procedure . | 1-month . | ||||
---|---|---|---|---|---|---|
. | BP-SES (n=20) . | DP-EES (n=20) . | P-value . | BP-SES (n=20) . | DP-EES (n=20) . | P-value . |
Struts analyzed (n) | 306±72 | 264±90 | 0.09 | 303±75 | 258±92 | 0.07 |
Stent area (mm2) | 6.4±1.8 | 6.7±1.8 | 0.59 | 6.7±2.1 | 6.7±1.9 | 0.98 |
Lumen area (mm2) | 6.4±1.8 | 6.7±1.7 | 0.59 | 6.5±2.1 | 6.5±1.9 | 0.96 |
% Uncovered strut (%) | 78.8±10.6 | 80.5±13.7 | 0.36 | 2.8±1.6 | 5.8±1.8 | <0.001 |
% Malapposed strut (%) | 7.1±5.3 | 2.9±2.6 | 0.004 | 2.5±3.1 | 2.4±2.2 | 0.76 |
Incidence of IS-Th (n (%)) | 13 (65.0%) | 11 (55.0%) | 0.54 | 6 (30.0%) | 7 (35.0%) | 0.75 |
Incidence of IRP (n (%)) | 6 (30.0%) | 5 (25.0%) | 0.74 | 0 (0%) | 0 (0%) |
. | Post-procedure . | 1-month . | ||||
---|---|---|---|---|---|---|
. | BP-SES (n=20) . | DP-EES (n=20) . | P-value . | BP-SES (n=20) . | DP-EES (n=20) . | P-value . |
Struts analyzed (n) | 306±72 | 264±90 | 0.09 | 303±75 | 258±92 | 0.07 |
Stent area (mm2) | 6.4±1.8 | 6.7±1.8 | 0.59 | 6.7±2.1 | 6.7±1.9 | 0.98 |
Lumen area (mm2) | 6.4±1.8 | 6.7±1.7 | 0.59 | 6.5±2.1 | 6.5±1.9 | 0.96 |
% Uncovered strut (%) | 78.8±10.6 | 80.5±13.7 | 0.36 | 2.8±1.6 | 5.8±1.8 | <0.001 |
% Malapposed strut (%) | 7.1±5.3 | 2.9±2.6 | 0.004 | 2.5±3.1 | 2.4±2.2 | 0.76 |
Incidence of IS-Th (n (%)) | 13 (65.0%) | 11 (55.0%) | 0.54 | 6 (30.0%) | 7 (35.0%) | 0.75 |
Incidence of IRP (n (%)) | 6 (30.0%) | 5 (25.0%) | 0.74 | 0 (0%) | 0 (0%) |
Type of funding source: None