7-Hexanoyltaxol–Eluting Stent for Prevention of Neointimal Growth An Intravascular Ultrasound Analysis From the Study to Compare REstenosis rate between QueST and QuaDS-QP2 (SCORE)
- Toru Kataoka; Eberhard Grube; Yasuhiro Honda; Yoshihiro Morino; Seung-Ho Hur; Heidi N. Bonneau; Antonio Colombo; Carlo Di Mario; Giulio Guagliumi; Karl E. Hauptmann; Mark R. Pitney; Alexandra J. Lansky; Simon H. Stertzer; Paul G. Yock; Peter J. Fitzgerald
- Keimyung Author(s)
- Dept. of Internal Medicine (내과학)
- Issue Date
- School of Medicine
- Circulation, Vol.106(14) : 1788-1793, 2002
- Background— Inhibition of neointimal tissue growth has been demonstrated in preliminary human feasibility studies with a stent-based polymer sleeve delivering 7-hexanoyltaxol. The Study to COmpare REstenosis rate between QueST and QuaDS-QP2 (SCORE) trial is a human, randomized, multicenter trial comparing 7-hexanoyltaxol (QP2)-eluting stents (qDES) with bare metal stents (BMS) in the treatment of de novo coronary lesions. The purpose of this substudy was to evaluate the acute expansion property and long-term neointimal responses of qDES compared with BMS as assessed by intravascular ultrasound (IVUS).
Methods and Results— A total of 122 (qDES 66, BMS 56) patients were enrolled into the IVUS substudy. All IVUS images (immediately after the procedure and at 6-month follow-up) were analyzed at an independent core laboratory in a blind manner. At baseline, qDES achieved stent expansion similar to BMS. At follow-up, qDES showed reduced neointimal growth by 70% at the tightest cross section and by 68% over the stented segment (P<0.0001 for both), resulting in a significantly larger lumen in qDES than in BMS. Unlike intracoronary brachytherapy, there was no evidence of negative edge effects, unhealed dissections, or late stent-vessel wall malapposition over the stented and adjacent references segments in either group.
Conclusions— Detailed IVUS analysis revealed that qDES had comparable acute mechanical and superior long-term biological effects to BMS. Although the long-term benefits and limitations of this technology require further investigation, the reduction in neointimal thickenings demonstrated that local delivery of 7-hexanoyltaxol through polymer sleeves augments conventional mechanical treatment of atherosclerotic disease.
Key Words: cardiovascular diseases
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