Abstract
Background: While there are controversies regarding the late clinical impact of post-procedural incomplete stent apposition (PISA) and late incomplete stent apposition (LISA), there has been limited data in the newer generation of drug eluting stent. The aim of this study was to investigate the morphologic change of PISA and incidence of LISA during 1 year follow up. Methods: We prospectively enrolled 128 patients who underwent percutaneous coronary intervention (PCI); stable angina (n=30), unstable angina (n=82), and non-ST segment elevation myocardial infarction (n=16) (61.2±10.4 years, 78 male, 194 lesions - 106 left anterior descending artery, 25 left circumflex artery, 63 right coronary artery). The implanted stent was randomly assigned (the proportion of 2:1), zotarolimus eluting stent (group I, n=130, Endeavor Resolute TM , Medtronic) or everolimus eluting stent (group II, n=64, Xience TM V, Abbott Vascular). Post-PCI and 1 year follow up intravascular ultrasound (IVUS) analysis were performed in all patients. Results: There were no baseline clinical, angiographic, and procedural differences between the two groups. The Post-PCI external elastic membrane (EEM) volume (group I vs group II, 377.2±111.8 vs 436.1±219.6 mm 3 , p =0.155), Post-PCI lumen volume (208.3±66.1 vs 233.8±112.3 mm 3 , p =0.283), 1 year EEM volume (387.4±106.8 vs 436.6±218.3 mm 3 , p =0.240), 1 year lumen volume (212.5±64.9 vs 231.9±112.5 mm 3 , p =0.395), and 1 year intra-stent neointimal hyperplasia volume (4.8±7.3 vs 5.2±17.6 mm 3 , p =0.914) by IVUS analysis were not different between the two groups. There were three LISA (1.5%, two Endeavor, one Xience), and ten PISA (5.2%, five Endeavor, five Xience) that were resolved (40%, three Endeavor, one Xience) or persistent (60%, two Endeavor, four Xience). However, both LISA and PISA did not associated with MACE during 1 year follow up. Conclusions: In conclusion, the incidence of both LISA and PISA was very low in new generation drug eluting stent. The morphologic healing or persistence of PISA during 1 year IVUS follow up was observed. Future larger long-term follow up study to clarify the clinical course of LISA and PISA would be needed.
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