Efficacy of reduced-dose sirolimus-eluting stents in the human coronary artery: Serial IVUS analysis of neointimal hyperplasia and luminal dimension
✍ Scribed by Mamoo Nakamura; Alexandre Abizaid; Atsushi Hirohata; Yasuhiro Honda; J. Edward Sousa; Peter J. Fitzgerald
- Publisher
- John Wiley and Sons
- Year
- 2007
- Tongue
- English
- Weight
- 212 KB
- Volume
- 70
- Category
- Article
- ISSN
- 1522-1946
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✦ Synopsis
Abstract
Study Objective:
Using serial intravascular ultrasound (IVUS), the efficacy of reduced‐dose sirolimus‐eluting stents (SESs) in the prevention of neointimal hyperplasia (NH) and maintenance of luminal patency in human coronary arteries was evaluated.
Background:
In the animal model, a broad therapeutic window regarding sirolimus doses in suppressing NH has been reported.
Methods:
Serial cross‐sectional and volumetric IVUS analyses were performed in 44 patients treated with SES that contained lower sirolimus doses (either 45% or 70%) than standard SES. For cross‐sectional analysis, minimum lumen area (MLA) was measured. Percent (%) NH volumetric obstruction was calculated as 100 × NH volume/stent volume.
Results:
IVUS measurements were similar between the two drug‐dose groups. At 12 months follow‐up, only one case developed late incomplete stent apposition. Between 4 and 12 months, a slight increase of in‐stent % area loss and % NH obstruction was noted (3.5% ± 10.4% to 6.7% ± 10.7% and 1.9% ± 5.0% to 4.4% ± 8.0%, respectively). The majority of studied cases, however, sustained less than a 10% volumetric (93% of studied cases) and area loss (75% of studied cases) in the stented segment up to 12 months. At 12 months, % area loss within the stented segments and 5‐mm reference segments were comparable (7.0% ± 19.6% versus 6.7% ± 10.7%).
Conclusions:
Although slight increases of NH were noted, SESs, delivering two reduced drug doses, appeared to be effective for maintaining luminal patency during 12 months follow‐up. © 2007 Wiley‐Liss, Inc.