Optical coherence tomography evaluation of late strut coverage patterns between first-generation drug-eluting stents and everolimus-eluting stent.
OBJECTIVES
To compare strut coverage patterns between everolimus-eluting stent (EES) and first-generation drug-eluting stents (DES) at more than 12 months after successful implantation, using optical coherence tomography (OCT).


BACKGROUND
No sufficient OCT data has been reported comparing late strut coverage patterns between EES and first-generation DES. The favorable late results after EES implantation could be related to lower rates of uncovered and malapposed struts.


METHODS
A total of 66 DES (21 EES, 23 SES, and 22 PES) that were implanted at least 1 year in advance in 40 patients and met good late angiographic results were evaluated by OCT. The percentage of uncovered and malapposed struts, calculated as the ratio of uncovered or malapposed struts to total struts in all cross-sectional images per stent, was compared among the three groups.


RESULTS
A total of 35,061 struts were analyzed: 11,967 from EES, 11,855 from SES, and 11m239 from PES. The average tissue coverage thickness of the struts per stent was greater in EES than in SES and PES (109 ± 40 µm vs. 72 ± 27 µm and 83 ± 26 µm, respectively; P = 0.001). The percentage of uncovered struts (1.9 ± 4.1% in EES vs. 11.6 ± 12.7% in SES, P = 0.01 and vs. 7.1 ± 5.2% in PES, P < 0.001) and malapposed struts (0.1 ± 0.3% in EES vs. 1.8 ± 3.5% in SES, P = 0.01 and vs. 3.5 ± 5.1% in PES, P = 0.02) was much lower in EES than in first-generation DES, with no significant differences between SES and PES.


CONCLUSIONS
Late strut coverage patterns are not similar between EES and first-generation DES. EES showed a lower percentage of uncovered and malapposed struts.
['Toledano Delgado|Francisco Javier|FJ|', 'Alvarez-Ossorio|Manuel Pan|MP|', 'de Lezo Cruz-Conde|José Suárez|JS|', 'Bellido|Francisco Mazuelos|FM|', 'Romero Moreno|Miguel Ángel|MÁ|', 'Fernández-Aceytuno|Alfonso Medina|AM|', 'de Lezo Herrerosde Tejada|Javier Suárez|JS|', 'Pineda|Soledad Ojeda|SO|', 'Saint-Gerons|José María Segura|JM|', 'Pavlovic|Djordje|D|']
D000368:Aged D015906:Angioplasty, Balloon, Coronary D015331:Cohort Studies D017023:Coronary Angiography D023921:Coronary Stenosis D003430:Cross-Sectional Studies D054855:Drug-Eluting Stents D019544:Equipment Failure Analysis D000068338:Everolimus D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D017239:Paclitaxel D011474:Prosthesis Design D011475:Prosthesis Failure D012680:Sensitivity and Specificity D020123:Sirolimus D013997:Time Factors D041623:Tomography, Optical Coherence
optical coherence tomography malapposed struts uncovered struts drug delivery neointimal coverage stent structure