Long-Term Follow-up of Neointimal Coverage of Sirolimus-Eluting Stents : Evaluation With Optical Coherence Tomography

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<b><i>Background:</i></b> Late stent thrombosis related to delayed neointimal growth is a major concern after drug-eluting stent (DES) implantation. The time course of neointimal growth and risk factors of uncovered stent struts after sirolimus-eluting stent (SES) was studied using optical coherence tomography (OCT). <b><i>Methods and Results:</i></b> The 60 patients were enrolled and classified into G1 (follow-up period <9 months, n=27), G2 (9-24 months, n=18), and G3 (>25 months, n=15). The time elapsed since SES implantation was associated with a significant increase in mean neointimal area and neointimal thickness, and also with a significant decrease in the number of uncovered stent struts (G1: 14.8%, G2: 11.7%, and G3: 4.1%, P<0.001). However, only 17.6% of implanted SES was completely covered by neointima, even in the G3 period. Small-diameter SES, complex coronary lesions with lipid and calcium content adjacent to stent struts, and diabetes predicted delayed neointimal coverage of SES struts in G1. <b><i>Conclusions:</i></b> Neointima inside SES progressively increases after the routine follow-up period, but only a few SES were completely covered at 3 years after implantation. OCT is a useful modality for assessing neointimal formation after SES implantation, and may give important information about the strategy of antiplatelet therapy after DES implantation. (<i>Circ J</i> 2009; <b>73:</b> 2300-2307)<br>


  • Circulation Journal

    Circulation Journal 73(12), 2300-2307, 2009-11-20

    The Japanese Circulation Society

References:  38

Cited by:  15


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