| 김지현, 오일영, 박경우, 나상훈, 이해영, 강현재, 구본권, 김효수, 오병희, 박영배 |
Background : Long-term intravascular ultrasound (IVUS) outcomes of 1st and 2nd generation drug-eluting stents (DES) have not been well-evaluated yet.
Objectives : We sought to assess 2 year IVUS findings of DES and compare IVUS findings between paclitaxel-eluting stent (PES) and zotarolimus-eluting stent (ZES).
Methods : From SNUH IVUS database, 70 patients with complete serial (post-stenting, early“6-month", and late“18-month”follow-up) angiographic and three dimensional IVUS data were included in this study (35 PES vs. 35 ZES). Vessel, stent, lumen, and peri-stent plaque volumes (vessel - stent) were assessed. % neointimal volume (%NIV) was calculated as [neointimal volume/stent volume x100,%].
Results : Changes in minimum lumen area (MLA) was greater during early follow-up period than in late follow-up period (-1.01 ± 1.16 mm2 vs. 0.11 ± 0.79 mm2, p=0.04). %NIV had the same trend (12.9 ± 8.7 % from baseline to 6 months and 0.43± 5.20 % from 6 to 18 months. p=0.005). The reduction of MLA during follow-up was not different between the two groups (PES: -0.96 ± 1.35mm2 vs.ZES: -1.05 ± 0.96mm2, p=0.76 at early FU, 0.15 ± 0.99mm2 vs. 0.07 ± 0.54mm2, p=0.65, at late follow-up). However, more neointima was developed in ZES than in PES during early follow-up (10.3 ± 7.8% vs. 15.6 ± 8.9%, p=0.01), but not during late follow-up (0.13 ± 5.67 % vs. 0.74 ± 4.75%, p=0.62). No difference in the incidence of late acquired mal-apposition between the two groups. Plaque and/or thrombus protrusion through stent struts was initially present in 17.1% of PES and 20% in ZES and all resolved during follow-up.
Conclusions : ZES, compared with PES, showed higher neointimal growth in early follow-up period. Although neointima continued to increase beyond 6 months after stent implantation, the rate of neointimal growth and luminal loss attenuated over time.
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