High incidence of thrombus formation at 18 months after paclitaxel-eluting stent implantation: angioscopic comparison with sirolimus-eluting stent

Am Heart J. 2010 May;159(5):905-10. doi: 10.1016/j.ahj.2010.02.032.

Abstract

Background: Difference of neointimal formational pattern and incidence of thrombus formation between sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) at 18 months after stent implantation has not previously been reported.

Methods: We retrospectively enrolled 35 event-free patients who received SES (15 patients, 18 stents) or PES (20 patients, 23 stents) implantation with 18-month follow-up coronary angioscopy. We divided our patients into SES or PES groups and compared neointimal coverage pattern and incidence of red mural thrombus formation between the 2 groups. Neointimal coverage grades were classified into 4 categories. Minimum neointimal coverage grade, maximum grade, and heterogeneity score were assessed in each stent. Heterogeneity score was calculated by subtracting minimum from maximum grade within one stent.

Results: Minimum neointimal coverage grade of PES was significantly lower than that of SES (0.70 +/- 0.64 vs 1.33 +/- 0.69, P = .005), whereas maximum grade was not significantly different (2.48 +/- 0.73 vs 2.22 +/- 0.73, P = .218). Heterogeneity score and incidence of red mural thrombus of PES were higher than those of SES (1.78 +/- 0.80 vs 0.89 +/- 0.76, P = .002 and 70% vs 11%, P < .001).

Conclusions: The present study revealed that PES shows more heterogeneous neointimal coverage and higher incidence of thrombus formation as compared with SES at 18 months after stent implantation.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary
  • Angioscopy
  • Coronary Restenosis / prevention & control
  • Coronary Thrombosis / diagnostic imaging
  • Coronary Thrombosis / epidemiology*
  • Coronary Vessels / diagnostic imaging
  • Drug-Eluting Stents*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paclitaxel / administration & dosage
  • Retrospective Studies
  • Sirolimus / administration & dosage
  • Ultrasonography, Interventional

Substances

  • Paclitaxel
  • Sirolimus