Abstract 458: Poor Progression of in-Stent Neoatherosclerosis in Patients With Everolimus-Eluting Stent Implantation: Coronary Angioscopic Observation
Very late stent thrombosis (VLST) is one of the most serious issues in the era of drug-eluting stents (DES). VLST has been attributed to delayed neointimal stent coverage (NSC) due to bio-suppressive drugs and vulnerability of in-stent neoatherosclerosis. The latter was recently proposed by pathologists as in-stent atherosclerotic lesions at chronic phase of coronary stenting. The aim of this study was angioscopic observation of in-stent vessel wall at 3 years after implantation of various generations of DES. Enrolled were 37 stented segments in 26 patients with stable angina (25 Cypher sirolimus-eluting stents, SES; 5 Endeavor zotarolimus-eluting stents, ZES; and 7 Xience V everolimus eluting stents, EES). Dual anti-platelet therapy, aspirin plus clopidogrel, had been continued since the stenting procedure. Coronary angiography showed no in-stent restenosis at chronic phase. Coronary angioscopy revealed the in-stent appearance; that is, grades of NSC [between score 0 (no coverage) and score 3 (full coverage)], presence of yellow plaque (YP), and subclinical stent thrombosis (ST). There was no significant difference in grades of NSC among SES, ZES, and EES (1.40±0.57, 1.71±0.77, and 1.80±0.75, respectively). YP and ST were not found in EES. YP was 24% and 20% in SES and ZES, respectively. ST was 20% both in SES and ZES. In conclusion, in-stent neoatherosclerosis appears not to progress at least for 3 years in EES-stented coronary segments, a representative of the second generation of DES.
Author Disclosures: M. Ichikawa: None. S. Yoshima: None. Y. Takei: None. K. Kawai: None. T. Oshita: None. K. Fukuda: None. T. Takagi: None. Y. Kijima: None.
- © 2014 by American Heart Association, Inc.