Optical coherence tomography evaluation of zotarolimus-eluting stents at 9-month follow-up: comparison with sirolimus-eluting stents

J-S Kim, I-K Jang, J-S Kim, T H Kim, M Takano, T Kume, N W Hur, Y-G Ko, D Choi, M-K Hong, Y Jang, J-S Kim, I-K Jang, J-S Kim, T H Kim, M Takano, T Kume, N W Hur, Y-G Ko, D Choi, M-K Hong, Y Jang

Abstract

Objective: To evaluate the vascular response at 9 months after zotarolimus-eluting stent (ZES; Endeavor) implantation using optical coherence tomography (OCT). These findings were compared with those after implantation of a sirolimus-eluting stent (SES; Cypher Select).

Design: Cross-sectional observational study with prospective OCT registry.

Setting: Nine months after ZES or SES implantation.

Patients and methods: A total of 68 patients (32 ZES and 36 SES) underwent OCT at 9 months after stent implantation. The neointima hyperplasia (NIH) thickness inside each strut and percentage of NIH area at every 1 mm cross section were measured.

Main outcome measurement: The degree of neointimal coverage and the prevalence of malapposition at 9 months after ZES and SES implantation using OCT.

Results: The mean (SD) NIH thickness (251.2 (110.0) mum vs 85.5 (53.3) mum, p<0.001) and percentage of NIH area (27.9 (9.1)% vs 11.2 (7.1)%, p<0.001) were significantly greater in ZES than in SES. The prevalence of uncovered strut as well as malapposed strut was significantly lower in ZES than in SES (0.3% vs 12.3%, p<0.001 and 0.08% vs 2.6%, p<0.001). Thrombus was not observed in ZES (0.0% in ZES vs 27.8% in SES, p = 0.001).

Conclusions: Neointimal coverage in ZES was almost complete and malapposition was very rare at 9-months' follow-up.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Representative optical coherence tomography images of zotarolimus-eluting stents (ZES) and sirolimus-eluting stents (SES). Completely covered struts (A) and thick neointima (B) were seen in ZES but malapposed and uncovered struts (C) and thin neointima (D) were seen in SES.
Figure 2
Figure 2
Difference in the rate of uncovered stent strut, malapposition and uncovered stent strut with malapposition on optical coherence tomography between zotarolimus-eluting stents (ZES) and sirolimus-eluting stents (SES).
Figure 3
Figure 3
Statistical distribution of neointimal hyperplasia (NIH) thickness of zotarolimus-eluting stents (ZES) and sirolimus-eluting stents (SES) (A). The proportions of NIH thickness beyond 1 SD between ZES and SES. The percentage of NIH thickness outside 1 SD was significantly lower in ZES than SES (B). The thickness of NIH at the thickest part or thinnest part was the mean NIH thickness at three consecutive cross sections at the corresponding part.

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Source: PubMed

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