Coronary angioscopic findings 9 months after everolimus-eluting stent implantation compared with sirolimus-eluting stents

AbstractObjectivesWe assessed angioscopic findings after everolimus-eluting stents (EES) implantation, compared with sirolimus-eluting stents (SES).BackgroundCoronary angioscopy (CAS) provides an opportunity to assess neointimal coverage over stent struts, thrombus, and plaque color by direct visualization. CAS is a useful tool for evaluating stent struts after drug-eluting stent implantation. Angioscopic findings after EES implantation have not been reported before.MethodsWe performed CAS in 23 patients who were treated with EES and 41 patients with SES. CAS was performed 8.5 months after stent implantation. We assessed neointimal coverage, thrombus, and plaque color. We classified neointimal coverage in 4 grades: grade 0=struts were completely exposed; grade 1=struts were visible with dull light reflexion; grade 2=there was no light reflexion from slightly visible struts; grade 3=struts were completely covered.ResultsThere was no significant difference in minimum, maximum, dominant grade of neointimal coverage, and heterogeneity index between EES and SES. Thrombus was less frequently observed in EES than SES (4% vs 29%, p=0.02). When we divided study patients into acute coronary syndrome (ACS) or stable angina pectoris (SAP), there was a tendency toward less thrombus in EES than SES, in both ACS and SAP. Maximum color grade of the plaques was less advanced in EES than SES (p<0.01). Yellow plaques of grade 2 or 3 were less frequent in EES than SES (35% vs 76%, p<0.01).ConclusionsThis study suggested that EES were associated with lower risk of thrombus formation than SES

Anatomical variation of PV in the PAF and non-PAF groups.

<p>Anatomical variation of PV in the PAF and non-PAF groups.</p

PV ostial area and LA diameter.

<p>PV ostial area and LA diameter.</p

PV volume and LA volume in the non-recurrent and recurrent groups.

<p>PV volume and LA volume in the non-recurrent and recurrent groups.</p

Identification of labeling of the left atrium (LA) in two-dimensional viewing.

<p>(a) LA top―mitral annulus diameter (dashed arrow). (b) LA longitudinal diameter (solid arrow). (c) LA anteroposterior diameter (solid arrow) and LA transverse diameter (dashed arrow).</p

Clinical characteristics of patients in the PAF and non-PAF groups.

<p>Clinical characteristics of patients in the PAF and non-PAF groups.</p

Three-dimensional volume-rendered reconstruction of the left atrium (LA) and pulmonary vein (PV).

<p>(a) Definition of the PV distal border as the first major branch in the simultaneously acquired voltage map (arrow head). (b) Definition of the PV―LA junction (dashed line). (c) Definition of the PV distal border and PV―LA junction. (d) Measurement of total PV volume and LA volume.</p

Pharmacological antiarrhythmic treatment pre- and post-ablation.

<p>Pharmacological antiarrhythmic treatment pre- and post-ablation.</p