Abstract
BackgroundQuestions persist regarding the ability of drug-eluting stents (DES) to inhibit intimal growth in the long-term. MethodsWe prospectively enrolled 766 lesions treated with DES that underwent angiographic examination at 6months and 2years after stenting. Lesions with 6-month restenosis (>50% of visual stenosis) were excluded. The primary end point was quantitative change in minimal lumen diameter (MLD) according to serial angiography of the segment (in-segment), the stented region (in-stent) and both edges. Late loss, defined as MLD change, was categorized as early (between post-procedure and 6months), delayed (between 6months and 2years), or overall (between post-procedure and 2-years). ResultsMLD progressively decreased in both the in-stent and edge regions at both 6months and 2years (p<0.001 in all paired analyses). In-segment MLD decreased from a median 2.27mm (interquartile range; 1.98, 2.62) at post-procedure to 2.18mm (1.86, 2.47; p<0.001 with post-procedure) at 6months, and to 2.02mm (1.66, 2.37; p<0.001 with 6months) at 2years. Late loss was 0.06mm (−0.05, 0.26) in the early phase, 0.09mm (−0.01, 0.28) in the delayed phase, and 0.20mm (0.03, 0.50) overall. Two-year angiographic restenosis occurred in 54 (7.0%) lesions, and 65 (8.5%) underwent target lesion revascularization over a median follow-up of 52.5months. ConclusionSerial angiographic analysis showed that DES lumen diameter progressively narrowed over 2years post-procedure. However, the incidence of target lesion revascularization was relatively low due to the small amount of late loss in the delayed phase.
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