Comparison of Sirolimus and Paclitaxel-Eluting Stents for Complex Coronary Lesions: An Intravascular Ultrasound Study
- Author(s)
- Yun-Kyeong Cho; Seung-Ho Hur; Hyun-Tae Kim; In-Cheol Kim; Hyoung-Seob Park; Hyuck-Jun Yoon; Chang-Wook Nam; Hyungseop Kim; Seong-Wook Han; Yoon-Nyun Kim; Kwon-Bae Kim
- Keimyung Author(s)
- Cho, Yun Kyeong; Hur, Seung Ho; Kim, In Cheol; Park, Hyoung Seob; Yoon, Hyuck Jun; Nam, Chang Wook; Kim, Hyung Seop; Han, Seong Wook; Kim, Yoon Nyun; Kim, Kwon Bae
- Department
- Dept. of Internal Medicine (내과학)
- Journal Title
- Korean Journal of Internal Medicine
- Issued Date
- 2009
- Volume
- 24
- Issue
- 4
- Keyword
- Coronary artery disease; Drug-eluting stents; Ultrasonography
- Abstract
- Background/Aims
Recent intravascular ultrasound (IVUS) studies of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) have demonstrated a significant reduction in neointimal hyperplasia (NIH) based on simple coronary lesions. In this study, we evaluated the efficacy of SES and PES using IVUS in complex coronary lesions.
Methods
Eighty-seven patients in whom 95 drug-eluting stents (66 SES and 29 PES) were implanted in complex coronary lesions were enrolled in this study. Case selection was based on the availability of IVUS and quantitative coronary angiographic (QCA) examinations at the index procedure and at follow-up. The neointimal volume index (volume/length: NIVI) and percent neointimal volume (% NIV) were calculated. The longitudinal length of stented segments without IVUS-detectable NIH was also evaluated.
Results
The baseline patient demographics were similar between the SES and PES groups. At follow-up, no significant differences were observed in the vessel, plaque, or stent volume indices between the two groups. However, the NIVI and % NIV were significantly lower in the SES group (p<0.01). The longitudinal length of stented segments without IVUS-detectable NIH was significantly higher in the SES group (p<0.01). The net gain was significantly larger in the SES group (2.3±0.7 vs. 2.0×0.6 mm, p=0.025), while the rate of major adverse cardiac events was similar between the two groups.
Conclusions
Although SES showed significantly greater suppression of NIH at follow-up, both stents were highly effective at inhibiting NIH in complex coronary lesions.
Keywords: Coronary artery disease, Drug-eluting stents, Ultrasonography
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