Abstract
Introduction: Uncovered and malapposed stent struts are risk of stent thrombosis in drug-eluting stents (DES). Second-generation DESs improved endothelial coverage and reduced stent thrombosis rate compared to those of first-generation DESs. However few studies have directly compared stent coverage using OCT between second-generation DESs (CoCr-EES or R-ZES) and new generation drug-eluting stents (platinum-chromium EES; PtCr-EES). The aim of this study is to compare OCT findings between CoCr-EES, R-ZES and PtCr-EES at 9 months after stent implantation. Methods: Total of 30 patients who underwent single stent implantation in de novo coronary arteries leasions without target lesion revascularization were included (10 CoCr-EESs, 10 PtCr-EESs and 10 R-ZESs). Cross-sectional OCT images were analyzed at 1-mm intervals. At every cross-section (CS), stent area and neointimal hyperplasia area (NIA) were measured and percent NIA [(NIA /stent area)[[Unable to Display Character: ☓]]100] were calculated. For each strut, neointimal thickness (NIT), malapposed and uncovered struts were assessed. Strut malapposition was defined as detachment from the vesell wall by >90μm for CoCr-EES, by >100μm for R-ZES, or by >90μm for PtCr-EES. Results: Total of 4646 struts and 588 CS were analyzed. Baseline patient and lesion characteristics were similar between 3 groups. In CoCr-EESs, NIT was thinner than the others (CoCr-EES: 70μm (30-130μm) vs. R-ZES: 80μm (40-150μm) vs. PtCr-EES: 90μm (50-140μm); p=0.0001). The percent NIA were similar among the groups (R-ZES: 8.1% vs. CoCr-EESs: 8.4% vs. PtCr-EES: 10%; p=0.18). PtCr-EESs had less frequency of malapposed (PtCr-EES: 0.08% vs. CoCr-EES: 0.4% vs. R-ZES: 0.9%, p=0.005) and uncovered (PtCr-EES: 0.94% vs. R-ZES: 2.2% vs. CoCr-EES: 3.4%; p=0.0001) struts than the others. Conclusions: PtCr-EESs had fewer uncovered struts and better stent apposition although greater NIT than CoCr-EESs and R-ZESs. These findings may suggest the fewer risks for stent thrombosis in PtCr-EESs.
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