Document Detail

Evaluation of four-year coronary artery response after sirolimus-eluting stent implantation using serial quantitative intravascular ultrasound and computer-assisted grayscale value analysis for plaque composition in event-free patients.
MedLine Citation:
PMID:  16256867     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study sought to evaluate the long-term arterial response after sirolimus-eluting stent implantation. BACKGROUND: Sirolimus-eluting stents are effective in inhibiting neointimal hyperplasia without affecting plaque volume behind the stent struts at six months. METHODS: Serial quantitative intravascular ultrasound and computer-assisted grayscale value analysis over four years were performed in 23 event-free patients treated with sirolimus-eluting stents. RESULTS: In the first two years, the mean plaque volume (155.5 +/- 42.8 mm3 post-procedure and 156.8 +/- 57.7 mm3 at two years, p = 0.86) and plaque compositional change expressed as mean percent hypoechogenic tissue of the plaque behind the stent struts (78.9 +/- 8.6% post-procedure and 78.2 +/- 8.9% at two years, p = 0.67) did not significantly change. However, significant plaque shrinking (change in plaque volume = -18.4 mm3, p = 0.02) with an increase in plaque echogenicity (change in percent hypoechogenic tissue = -7.8%, p < 0.0001) was observed between two and four years. The mean neointimal volume increased over four years from 0 to 8.4 +/- 5.8 mm3 (p < 0.0001). However, no further statistically significant change occurred between two and four years (7.0 +/- 6.7 mm3 vs. 8.4 +/- 5.8 mm3, p = 0.25). CONCLUSIONS: Between two and four years after sirolimus-eluting stent implantation, peri-stent tissue shrank with a concomitant increase in echogenicity. These intravascular ultrasound findings suggest that late chronic artery responses may evolve for up to four years after sirolimus-eluting stent implantation. In addition, the fact that the neointima does not significantly change from two to four years may suggest that the biological phenomenon of a delayed healing response has begun to subside.
Jiro Aoki; Alexandre C Abizaid; Patrick W Serruys; Andrew T L Ong; Eric Boersma; J Eduardo Sousa; Nico Bruining
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Publication Detail:
Type:  Journal Article     Date:  2005-10-10
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  46     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-31     Completed Date:  2005-12-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1670-6     Citation Subset:  AIM; IM    
Erasmus Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Combined Modality Therapy
Coronary Artery Disease / pathology,  therapy*,  ultrasonography*
Diagnosis, Computer-Assisted*
Drug Delivery Systems
Hyperplasia / prevention & control
Middle Aged
Sirolimus / administration & dosage*
Time Factors
Tunica Intima / pathology*
Ultrasonography, Interventional*
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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