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Impact of Stent Platform of Paclitaxel-Eluting Stents

2012; Japanese Circulation Society; Volume: 76; Issue: 8 Linguagem: Inglês

10.1253/circj.cj-11-1363

1347-4820

Hiromasa Otake, Junya Shite, Toshiro Shinke, Naoki Miyoshi, Amane Kozuki, Hiroyuki Kawamori, Masayuki Nakagawa, Ryoji Nagoshi, Hirotoshi Hariki, Takumi Inoue, Tsuyoshi Osue, Yu Taniguchi, Noritoshi Hiranuma, Ryo Nishio, Hiroto Kinutani, Ken–ichi Hirata,

Peripheral Artery Disease Management

Background: The Taxus Express™ paclitaxel-eluting stent (Express-PES) and Taxus Liberté™ PES (Liberté-PES) have identical drugs, drug doses, and polymers, but different stent platforms. The Liberté-PES platform has thinner struts, specifically designed for more uniform drug elution. Methods and Results: Fifty-four patients who underwent 6-month follow-up optical coherence tomography (OCT) after Express-PES (n=27) or Liberté-PES (n=27) implantation were enrolled. Longitudinal and circumferential uniformity of neointimal distribution was evaluated in 3-D by computing mean neointimal thickness (NIT) within 360 equally spaced radial sectors for every 1-mm cross-section. After stenting, intravascular ultrasound showed that Liberté-PES had a significantly smaller maximum angle between adjacent struts, with a tendency toward a lower incidence of % length of the segment with maximum angle >90° than Express-PES. Liberté-PES had a significantly thinner mean NIT than the Express-PES with comparable frequency of uncovered struts. Longitudinal and circumferential absolute variation of NIT expressed by standard deviation of NIT from each sector was significantly smaller for Liberté-PES than for Express-PES. Liberté-PES had a tendency toward a decreased incidence of thrombus and peri-strut low-intensity areas (findings suggestive of delayed arterial healing), compared to Express-PES. Conclusions: Stent design and thickness appeared to affect neointima suppression of PES. The stent platform of the Liberté-PES may offer greater and more homogeneous reduction of neointimal proliferation spatially across the full length of the PES. (Circ J 2012; 76: 1880–1888)