Abstract 9316: Serial Changes of Neointimal Coverage Condition and Characteristic are Different between Sirolimus-Eluting Stents, Paclitaxel-Eluting Stents and Zotalolimus-Eluting Stents Implantation: Follow-Up Optical Coherence Tomography Study

Abstract

Background: The long-term detailed changes of neointima coverage in Sirolimus-eluting stent(SES), Paclitaxel-eluting stent(PES) and Zotalolimus-eluting stent( ZES) remains to be clarified. Methods: Of 20 SES (14 patients),13 PES (12 patients) and 9 ZES(7patients)Optical Coherence Tomography( OCT) was used to visualize 2486, 1361 and 1018 stent-struts at 8 months and 2199, 1309 and 1001 stent-struts at 20 months after respectively. The OCT parameters, including incidence of uncovered struts and malapposed struts and averaged neiointimal hyperplasia thickness (NIH) and NIH% = NIH area / stent area, were compared between 8 months and 20 months follow-up. The neointimal charecteristics were classified into 3 groups: homogenous without PLIA(high density neointima without peri-strut low-intensity area(PLIA);homogenous with PLIA (high density neointima with PLIA);heterogenous (low density neointima and layered neointima) .PLIA was defined as a region around stent struts with a homogeneous,lower intensity appearance than the surrounding tissue on OCT images without significant signal attenuation. Results: Serial OCT study revealed that the prevalence of uncovered struts decreased in SES, PES and ZES and the prevalence of malapposed struts did not change in SES, PES and ZES. Average NIH and NIH% significantly increased in SES, but average NIH and NIH% significantly decreased in PES and did not change in ZES from 8 months to 20 months. Homogenous without PLIA was most frequent in ZES. It was not different between SES and PES. Homogenous without PLIA increased from 8month to 20month after in PES and ZES,but in SES decreased. Homogenous with PLIA(It suggesting the presence of fibrinoid, proteoglycans, macrophages and lymphocytes pathologically) increased in SES. Conclusions: Uncovered struts gradually alleviated in SES,PES and ZES while neointimal hyperplasia condition showed different patters. Neointimal characteristics showed different patterns too.