Author + information
- Hideki Kitahara,
- Teruyoshi Kume,
- Katsuhisa Waseda,
- Kenji Sakamoto,
- Ryotaro Yamada,
- Paul G. Yock,
- Alan C. Yeung,
- Peter J. Fitzgerald and
- Yasuhiro Honda
The aim of this study was to evaluate whether IVUS or angiographic parameters during mid–term follow–up (FU) can predict late target lesion revascularization (TLR) in lesions treated with Endeavor (E–ZES) and Resolute zotarolimus–eluting stents (R–ZES).
Clinical outcomes were followed for up to 5 years in 953 lesions (753 E–ZES; 200 R–ZES) with no TLR within the first 12 months. Quantitative angiography and volumetric IVUS were performed at baseline (BL) and mid–term (9–12 months) FU.
Late–TLR (>12 months) occurred in 1.3% of E–ZES and 4.0% of R–ZES lesions. The amount of neointima at mid–term FU did not predict the late–TLR in either stents. In E–ZES, lumen dimensions at mid–term FU tended to be smaller in late–TLR, whereas they did not predict late–TLR in R–ZES. Serial IVUS showed stable and comparable peri–stent dimensions in E–ZES between late–TLR vs no–TLR lesions. In contrast, late–TLR of R–ZES had larger plaque at BL, followed by greater increases of vessel and plaque from BL to mid–term FU, resulting in larger vessel and plaque at mid–term FU compared with no–TLR lesions.
This study suggests that the determinants of late–TLR depend on the type of drug carrier and release kinetics. The low incidence of late–TLR and no significant change of the stented vessel may represent healing and stability of the treated vessel after E–ZES implantation. Late–TLR of R–ZES appears to be related to arterial responses of the stented vessel observed during the first 9–12 months.
Comparisons Between Late vs. no–TLR Lesions Treated with E–ZES and R–ZES
|Late-TLR (n=10)||No-TLR (n=743)||p||Late-TLR (n=8)||No-TLR (n=192)||p|
|Vessel volume (mm3/mm)||13.4±6.0||14.1±4.9||0.709||16.7±6.0||14.0±3.9||0.110|
|Plaque volume (mm3/mm)||7.0±4.8||7.0±2.9||0.979||8.8±4.0||6.6±2.5||0.047|
|Vessel volume (mm3/mm)||14.1±7.1||14.8±4.1||0.695||18.8±7.1||13.8±3.9||0.008|
|Plaque volume (mm3/mm)||7.9±5.6||7.6±2.6||0.783||10.2±4.6||6.7±2.3||0.002|
|Minimum lumen area (mm2)||4.0±1.8||4.9±1.7||0.208||5.9±1.5||5.7±1.8||0.780|
|Neointimal obstruction (%)||15.6±7.2||15.5±10.0||0.989||4.6±4.3||4.1±4.6||0.783|
|From baseline to mid-term FU|
|Δ vessel volume (mm3/mm)||0.4±0.3||0.2±1.7||0.855||1.3±0.8||0.2±1.1||0.031|
|Δ plaque volume (mm3/mm)||0.4±0.3||0.09±1.1||0.535||0.8±0.5||0.1±0.6||0.023|
|Angiography at mid-term FU|
|Minimum lumen diameter (mm)||1.8±0.5||2.1±0.5||0.097||2.3±0.3||2.4±0.5||0.738|
|Diameter stenosis (%)||28.9±20.8||23.0±13.7||0.230||17.7±12.2||10.3±13.9||0.165|
|Late lumen loss (mm)||0.7±0.4||0.6±0.4||0.306||0.4±0.4||0.2±0.3||0.110|
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Intravascular Imaging: IVUS and OCT
Abstract Category: 38. TCT@ACC–i2: Intravascular Imaging and Physiology
Presentation Number: 2108M–235
- 2013 American College of Cardiology Foundation