Document Detail


An intravascular ultrasound study of Cypher, Taxus, and endeavor stents on relation between neointimal proliferation and residual plaque burden.
MedLine Citation:
PMID:  18973509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Studies on balloon angioplasty, atherectomy, and bare metal stent have shown a direct relation between residual plaque burden and restenosis. We investigated the relation between residual plaque burden and neointimal proliferation after drug-eluting stent (DES) implantation. METHODS: Over a period of 12 months, 65 patients (Cypher, n = 25; Taxus, n = 28; Endeavor, n = 12) from two centers underwent intravascular ultrasound (IVUS) examination at 8.2 (interquartile range 6.8-9.5) months after coronary stent implantation in native de novo coronary arteries. IVUS images were acquired with motorized pullback at 0.5 mm/s, and cross-sectional measurements were performed within the stents at 1-mm intervals. The following measurements were obtained: (1) lumen area (LA), (2) stent area (SA), (3) external elastic membrane area (EEMA), (4) percent neointimal hyperplasia area (SA-LA/SA) x 100, and (5) percent residual plaque area (EEMA-SA)/EEMA x 100. RESULTS: The analysis of 1,173 cross sections (Cypher, n = 436; Taxus, n = 532, Endeavor, n = 205) using mixed model to account for intrasubject correlation showed an absence of relation between percent residual plaque area and percent neointimal hyperplasia area (P = 0.189). Mean residual plaque burden outside the stent for Cypher, Taxus, and Endeavor groups was similar (45.7%, 44.8%, and 42.4%, respectively). Mean percent neointimal hyperplasia area for the Cypher, Taxus, and Endeavor groups was 12.0%, 15.0%, and 16.2%, respectively (P = 0.163). CONCLUSION: In patients after first-generation DES implantation and without significant in-stent restenosis, late in-stent neointimal proliferation is not related to the amount of residual plaque burden after stent implantation. This suggests against routine plaque removal before DES implantation to reduce neointimal proliferation.
Authors:
Chi-Hang Lee; Junjie Zhang; Anand Kailasam; Bee-Choo Tai; Fei Ye; Adrian F Low; Xumin Hou; Edourdo Tin Hay; Swee-Guan Teo; Yean-Teng Lim; Shaoliang Chen; Huay-Cheem Tan
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Publication Detail:
Type:  Journal Article     Date:  2008-10-21
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  21     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-21     Completed Date:  2009-05-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  519-27     Citation Subset:  IM    
Affiliation:
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. mdclchr@nus.edu.sg
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Angiography
Coronary Restenosis / epidemiology*,  therapy*,  ultrasonography
Coronary Vessels / ultrasonography*
Databases, Factual
Drug-Eluting Stents*
Female
Hospitals
Humans
Male
Middle Aged
Prospective Studies
Taxus

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


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