Abstract 2770: Neointimal Hyperplasia Patterns Among 3 Drug-Eluting Stents: A Comparative Intravascular Ultrasound Analysis of Everolimus-, Sirolimus-, and Paclitaxel-Eluting Stents

Abstract

Background The amount of neointimal hyperplasia as well as the percentage of neointimal stent surface coverage may be different among various types of drug-eluting stents (DES). Methods From the Stanford University Intravascular Ultrasound (IVUS) Core Laboratory database, this study consisted of the patients enrolled in prospective, multicenter clinical trials with DES deployment for de novo coronary lesions and 3-D IVUS at 8- to 9-month follow-up as part of their study protocol. In these cases, 155 single DES: (1) an 18-mm everolimus-eluting (EES, 52 stents in 50 patients); (2) an 18-mm sirolimus-eluting (SES, 51 stents); or (3) a 16-mm paclitaxel-eluting (PES, 52 stents) stent in 153 patients were investigated. Using Simpson’s rule, %neointimal volume was defined as neointimal volume / stent volume × 100. Circumferential stent length covered with neointima (L N ) and stent perimeter (L S ) were also measured at every 1-mm cross section throughout the stent. Then, %neointimal coverage was defined as total L N / total L S × 100. Results EES had comparable %neointimal volume to SES, but less %neointimal volume than PES (5.2±5.3 vs 2.6±4.0 vs 9.2±8.7%, P< 0.0001), whereas EES had greater %neointimal coverage than SES, but comparable %neointimal coverage to PES (25.7±19.9 vs 9.1±14.6 vs 29.3±23.5%, P< 0.0001). Conclusions Compared to SES, EES had comparable neointimal hyperplasia, but greater neointimal stent coverage by IVUS. Compared to PES, EES had less neointimal hyperplasia, but comparable neointimal stent coverage by IVUS. This unique pattern of neointimal hyperplasia with these platforms may be important to the balance of the short-term efficacy and the long-term safety.