Optical coherence tomography evaluation of intermediate-term healing of different stent types: systemic review and meta-analysis.
- Iannaccone M Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy mario.iannaccone@hotmail.it.
- D'Ascenzo F Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy.
- Templin C University Heart Center, Cardiology, University Hospital, Zurich, Switzerland.
- Omedè P Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy.
- Montefusco A Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy.
- Guagliumi G Cardiovascular Department, Ospedali Riuniti di Bergamo, Bergamo, Italy.
- Serruys PW Department of Interventional Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands.
- Di Mario C National Institute of Health Research Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, UK.
- Kochman J Department of Cardiology, Warsaw Medical University, Warszawa, Poland.
- Quadri G Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy.
- Biondi-Zoccai G Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
- Lüscher TF University Heart Center, Cardiology, University Hospital, Zurich, Switzerland.
- Moretti C Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy.
- D'amico M Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy.
- Gaita F Division of Cardiology, Città Della Salute e Della Scienza, Turin, Italy.
- Stone GW Division of Cardiology, Columbia University Medical Center, New York, NY, USA.
- 2016-04-22
Published in:
- European heart journal cardiovascular Imaging. - 2017
BV
EES
OCT
drug-eluting stent
neointima thickness
optical coherence tomograph
strut malapposition
strut uncoverage
Adult
Aged
Angioplasty, Balloon, Coronary
Cohort Studies
Coronary Stenosis
Drug-Eluting Stents
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prosthesis Failure
Randomized Controlled Trials as Topic
Retrospective Studies
Risk Assessment
Stents
Time Factors
Tomography, Optical Coherence
Treatment Outcome
English
AIMS
The intermediate-term incidence of strut malapposition (SM) and uncovered struts (US), and the degree of neointimal thickness (NIT) according to stent type have not been characterized.
METHODS AND RESULTS
All studies of >50 patients in which optical coherence tomography was performed between 6 and 12 months after stent implantation were included. The incidences of SM and US were the co-primary end points, while NIT was the secondary end point. A total of 458 citations were initially appraised at the abstract level, and 11 full-text studies (280 652 analysed struts, 921 patients) were assessed. The 6-12 months incidences of SM and US were 5.0 and 7.8%, respectively, and the mean NIT was 206 μm. Biolimus-eluting stents (BES) and bioresorbable vascular scaffolds (BVS) had the highest SM rates (2.7 and 3.8%, respectively), while everolimus-eluting stents (EES) and fast-release zotarolimus-eluting stents (ZES) had the lowest SM rates (0.9 and 0.1%, respectively). BES and sirolimus-eluting stents (SES) had the highest US rates (7.7 and 8.8%, respectively), while bare metal stents (BMS) and ZES had the lowest US rates (0.3 and 0.3%, respectively). BMS had the greatest NIT (340 μm), while SES, EES, and BES had the least NIT.
CONCLUSION
Second-generation drug-eluting stents (DES) have better intermediate-term strut apposition and coverage than first-generation DES, BVS, and BMS. EES demonstrate the overall best combination of healing with suppression of neointimal hyperplasia at 6-12 months. Further studies with clinical correlation are warranted to determine the implications of these findings.
The intermediate-term incidence of strut malapposition (SM) and uncovered struts (US), and the degree of neointimal thickness (NIT) according to stent type have not been characterized.
METHODS AND RESULTS
All studies of >50 patients in which optical coherence tomography was performed between 6 and 12 months after stent implantation were included. The incidences of SM and US were the co-primary end points, while NIT was the secondary end point. A total of 458 citations were initially appraised at the abstract level, and 11 full-text studies (280 652 analysed struts, 921 patients) were assessed. The 6-12 months incidences of SM and US were 5.0 and 7.8%, respectively, and the mean NIT was 206 μm. Biolimus-eluting stents (BES) and bioresorbable vascular scaffolds (BVS) had the highest SM rates (2.7 and 3.8%, respectively), while everolimus-eluting stents (EES) and fast-release zotarolimus-eluting stents (ZES) had the lowest SM rates (0.9 and 0.1%, respectively). BES and sirolimus-eluting stents (SES) had the highest US rates (7.7 and 8.8%, respectively), while bare metal stents (BMS) and ZES had the lowest US rates (0.3 and 0.3%, respectively). BMS had the greatest NIT (340 μm), while SES, EES, and BES had the least NIT.
CONCLUSION
Second-generation drug-eluting stents (DES) have better intermediate-term strut apposition and coverage than first-generation DES, BVS, and BMS. EES demonstrate the overall best combination of healing with suppression of neointimal hyperplasia at 6-12 months. Further studies with clinical correlation are warranted to determine the implications of these findings.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1093/ehjci/jew070
- PMID 27099274
- Persistent URL
- https://folia.unifr.ch/global/documents/66442
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