Comparison of edge vascular response after sirolimus- and paclitaxel-eluting stent implantation

Abstract

Background: To compare the edges vascular response, we analyzed the intravascular ultrasound (IVUS) parameters after implantation of the sirolimus-eluting stent (SES) or the paclitaxel-eluting stent (PES). Methods: Two hundred-two angina patients (123 men; 61.5 +/- 9.2 years of age, SES: n=91, PES: n=111) were enrolled. Both edge segments of the stent were analyzed. The change (Delta) of each parameter at follow-up was calculated. Results: The edge restenosis rate was higher in the PES group. However, the Delta Vessel, Delta Plaque and Delta Lumen volume at 5 mm edge segments were not different between the two groups except the Delta Plaque volume at the distal segment, higher in the PES than the SES group (6.6 +/- 15.7 vs. 1.0 +/- 13.1mm(3), P=.016). In the PES group, lumen area at the both 1 mm edge segments decreased because of plaque progression (proximal, 1.9 +/- 1.5 to 2.2 +/- 2.0 mm(2), P=.095; distal, 0.6 +/- 1.1 to 1.0 +/- 1.4 mm(2), P=.018) with negative remodeling (proximal, 9.9 +/- 2.4 to 9.4 +/- 2.6 mm(2), P=.004; distal, 7.6 +/- 2.4 to 7.2 +/- 2.4 mm(2), P=.052). Conversely, lumen area at these segments increased due to plaque regression (proximal, 3.2 +/- 1.8 to 2.1 +/- 1.6 mm(2), P=.000; distal, 1.5 +/- 1.4 to 0.9 +/- 1.3 mm(2), P=.000) even though there was negative remodeling in the SES group (proximal, 10.1 +/- 2.4 to 9.6 +/- 2.3 mm(2), P=.019; distal, 7.8 +/- 2.3 to 7.5 +/- 2.3 mm(2), P=.074). The. Plaque and. Lumen area at the both 1 mm edge segments were more prominent in the PES group. Conclusions: Compared to SES, PES was associated with luminal reduction accompanied by plaque progression with negative remodeling at edge segments. (C) 2011 Elsevier Ireland Ltd. All rights reserved.