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ȣ - 540625 247 |
| Comparison of Two Different Paclitaxel-Eluting Stents (Coroflex Please vs. TAXUS) for Intimal Hyperplasia and Vascular changes: Volumetric Intravascular Ultrasound Analysis. |
| 서울대학교병원 순환기내과 |
| 김지현, 오일영, 박경우, 나상훈, 이해영, 강현재, 구본권, 김효수, 오병희, 박영배 |
Background: Intravascular evaluation of newly developed paclitaxel eluting stent, Coroflex Please, has not been evaluated yet.
Objective: ECO-PLEASANT trial is a multicenter, prospective randomized trial compared clinical efficacy, angiographic outcomes, and safety of CoroflexTM Please with another paclitaxel-eluting TaxusTM. In this study, we evaluated neointimal hyperplasia (NIH) and vascular changes after stent implantation using serial volumetric intravascular ultrasound (IVUS) analysis.
Methods : Complete serial angiographic and volumetric IVUS data at immediate post-stenting and 9-month follow-up were available for 87 cases : 42 Coroflex group and 45 Taxus group. Baseline and follow-up vessel, stent, lumen and peri-stent plaque volume (vessel minus stent) were assessed. Percent of neointimal volume obstruction was calculated as [NIH volume/stent volume X 100, %].
Results : At 9-month follow-up, changes in minimal luminal area (MLA) were similar between the two groups (Taxus: -0.93±1.08mm2 vs. Coroflex : -0.97±1.20 mm2, p=0.87). %NIH volume was also not different between the two groups (Taxus: 13.1±11.0% vs. Coroflex: 12.1 ± 7.7%, p=0.64). Late stent malapposition was identified 10 in Coroflex group and 5 in Taxus group. The rate of target lesion revascularization was higher in Coroflex group.
Conclusion : The degree of neointimal growth in coroflex group was similar to taxus group at 9-month follow-up despite the higher event rate. This finding may reflect the high inter-individual variability in response to Coroflex stent.
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Variable |
After stenting |
9 Months of Follow-up |
|
Drug etluting stent |
TaxusTM |
Coroflex TM |
P-value |
TaxusTM |
Coroflex TM |
P-value |
|
Lesions (n) |
45 |
42 |
45 |
42 |
|
Minimum lumen area (mm2) |
5.4 ± 1.8 |
5.1 ± 1.9 |
0.45 |
4.5 ± 1.7 |
4.1 ±2.0 |
0.4 |
|
Lumen volume index (mm3/mm) |
6.8 ± 1.9 |
6.6 ± 2.1 |
0.62 |
6.1 ± 1.9 |
5.9 ± 2.2 |
0.7 |
|
Vessel volume index(mm3/mm) |
13.6 ±3.8 |
13.8 ± 3.9 |
0.80 |
14.6 ± 4.2 |
14.4 ± 4.1 |
0.8 |
|
Plaque volume index (mm3/mm) |
6.5 ± 2.7 |
7.1 ± 2.5 |
0.40 |
8.6 ± 3.0 |
8.4 ± 2.3 |
0.79 |
|
Stent volume index (mm3/mm) |
6.9 ± 2.0 |
6.6 ± 2.1 |
0.61 |
7.0 ± 2.1 |
6.7 ± 2.2 |
0.49 |
|
NIH volume index (mm3/mm) |
|
|
|
1.0 ± 0.8 |
0.8 ± 0.5 |
0.26 |
|
% NIV obstruction |
0.7 ± 2.8 |
0.6 ± 0.1 |
0.79 |
13.8 ± 10.7 |
12.7 ± 7.7 |
0.59 |
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