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Recent pivotal clinical trials have shown an excellent long-term safety of cobalt-chromium everolimus-eluting stent (CoCrEES). However, the impact of lesion complexity and overlapping segments on long-term vascular response to CoCrEES remains unclear.
A total of 47 patients with 58 lesions treated only with CoCrEES and no target-vessel events within 5 years after implantation were prospectively enrolled and underwent 5-year follow-up optical coherence tomography (OCT). Quantitative parameters and qualitative characteristics of the neointima were evaluated using multilevel logistic or linear regression models with random effects at three levels: lesion, cross-section (CS), and strut. According to the lesion complexity, the lesions were classified into the two groups: the complex lesion (CL) and non-CL group.
A total of 11034 struts (CL, n=6240; non-CL, n=4794) and 1202 (CL, n=683; non-CL, n=519) CSs were analyzed. The percentage of uncovered and malapposed struts did not differ significantly between the CL and non-CL groups (0.90% vs. 0.54%, P=0.78; 0.56% vs. 0.10%, P=0.16, respectively). The incidence of neoatherosclerosis was comparable between both groups in the CS- and lesion-level analysis (3.5% vs. 4.6%, P=0.91; 32.0% vs. 24.2%, P=0.52, respectively). The percentage of uncovered and malapposed struts and the incidence of neoatherosclerosis did not significantly differ between overlapping and non-overlapping segments (1.1% vs. 0.73, P=0.80; 0.0% vs. 0.37%, P=1.00; 0.0% vs. 4.1%, P=1.00, respectively).
At 5 years, CoCrEES shows an excellent vascular healing and similar frequency of neoatheroslerosis in patients without target-vessel events, regardless of the lesion complexity and overlapping segments.
IMAGING: Imaging: Intravascular