Three- and 6-month optical coherence tomographic surveillance following percutaneous coronary intervention with the Angiolite® drug-eluting stent: The ANCHOR study.
نویسندگان
چکیده
BACKGROUND Pre-clinical results of a novel open-cell, thin strut, durable polymer, laser cut cobalt chromium sirolimus-eluting stent (Angiolite) were promising. Using quantitative optical coherence tomographic (OCT) analyses, we explored the healing characteristics of the Angiolite DES system at 3- and 6-months post implantation. METHODS A total of 103 patients with de novo coronary lesions underwent percutaneous coronary intervention with the Angiolite DES and were randomized 1:3 into two cohorts for angiographic and OCT follow-up, with 28 and 70 patients returning for 3- or 6-month post-PCI surveillance, respectively. The primary endpoints were the 6-month rates of OCT-derived neointimal proliferation, strut coverage and incomplete strut apposition (ISA), whilst the secondary endpoints were 3-month OCT-derived measures of strut coverage and ISA, as well as 6-month quantitative coronary angiographic-derived measures [late lumen loss (LLL), binary restenosis]. RESULTS The Angiolite stent was successfully implanted in all patients, without periprocedural complications. At 3- and 6-months follow-up, OCT strut coverage was evident in 86.3% and 83.3% of struts, mean neointimal thickness was 73.7 ± 46.5 μm and 73.9 ± 54.3 μm, mean neo-intimal area obstruction of 5.8% ±10.3% and 4.4% ± 11.3%, and ISA rates were 1.3% ± 7.3% and 1.1% ± 6.2%, respectively. In-stent LLL at 6 months was 0.07 ± 0.37 mm, with a binary in-stent angiographic restenosis rate of 0% without any stent thrombosis, myocardial infarction or cardiovascular death, with 1 patient undergoing ischemia-driven target-lesion revascularization. CONCLUSIONS At 6 months, the Angiolite DES was safe with high rates of strut coverage, modest degrees of neointimal hyperplasia and very low rates of strut malapposition. These data coupled with the absence of in-stent binary restenosis and a very low 6-month in-stent LLL point towards an efficacious DES. Future studies are required to evaluate its efficacy in broader lesion subsets with longer follow-up.
منابع مشابه
Randomized comparison of stent strut coverage following angiography- or optical coherence tomography-guided percutaneous coronary intervention.
INTRODUCTION AND OBJECTIVES The clinical benefits of optical coherence tomography-guided percutaneous coronary intervention are unclear. Therefore, in this study we sought to evaluate the impact of optical coherence tomography guidance on stent strut coverage following drug-eluting stent implantation. METHODS A total of 101 patients in 105 lesions were randomly assigned to receive percutaneou...
متن کاملOverview of Intracoronary Brachytherapy for in-Stent Restenosis of a Drug-Eluting Stent
Percutaneous coronary intervention with stenting is considered recently as the most common procedure for the treatment of symptomatic coronary. The article reviewed 41 studies published during 1997-2019 on intracoronary brachytherapy for in-stent restenosis of a drug-eluting stent. Intracoronary radiation therapy was finally confirmed in the setting of in-stent restenosis using as adjunctive th...
متن کاملMechanisms of late stent-related myocardial infarction: insights from optical coherence tomography
This article focuses on optical coherence tomography findings in patients with late major cardiovascular events like myocardial infarction and/or stent thrombosis, following drug-eluting stent and bare-metal stent implantation. Uncovered stent struts and malapposition seem to play a critical role in drug-eluting stent-related late events. Neointimal features similar to native atherosclerosis ar...
متن کاملAssociation of G22A variant of Adenosine Deaminase gene with coronary in-stent restenosis in coronary artery patients receiving drug-eluting stent
In-stent restenosis (ISR) is regarded as the main problem in the utilization of stents in the treatment of coronary artery atherosclerotic stenosis in percutaneous coronary intervention (PCI). This study investigated the possible role of the G22A variant of the Adenosine Deaminase gene (ADA) in the development of ISR. In this study, 91 patients who underwent PCI were divided into two groups of ...
متن کاملOptical Coherence Tomography Guided Percutaneous Coronary Intervention With Nobori Stent Implantation in Patients With Non-ST-Segment-Elevation Myocardial Infarction (OCTACS) Trial: Difference in Strut Coverage and Dynamic Malapposition Patterns at 6 Months.
BACKGROUND Incomplete strut coverage has been documented an important histopathologic morphometric predictor for later thrombotic events. This study sought to investigate whether optical coherence tomography (OCT)-guided percutaneous coronary intervention with Nobori biolimus-eluting stent implantation in patients with non-ST-segment-elevation myocardial infarction would provide improved strut ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
دوره 91 3 شماره
صفحات -
تاریخ انتشار 2018