TY - JOUR
T1 - Chronic Arterial Responses to Overlapping Paclitaxel-Eluting Stents. Insights From Serial Intravascular Ultrasound Analyses in the TAXUS-V and -VI Trials
AU - Aoki, Jiro
AU - Mintz, Gary S.
AU - Weissman, Neil J.
AU - Mann, J. Tift
AU - Cannon, Louis
AU - Greenberg, Joel
AU - Grube, Eberhard
AU - Masud, A. R.Zaki
AU - Koglin, Joerg
AU - Mandinov, Lazar
AU - Stone, Gregg W.
N1 - Funding Information:
Drs. Mintz, Weissman, Mann, Cannon, Greenberg, Grube, and Stone have received research grants from Boston Scientific; Drs. Mintz, Weissman, and Cannon are on Boston Scientific Speaker’s Bureau and have received honoraria; Drs. Mintz, Weissman, Cannon, Greenberg, and Stone are on the Boston Scientific Consultant/Advisory Boards; and Drs. Koglin and Mandinov are employed by Boston Scientific.
PY - 2008/4
Y1 - 2008/4
N2 - Objectives: The purpose of this study was to use intravascular ultrasound (IVUS) to investigate chronic arterial responses at the site of and adjacent to overlapping paclitaxel-eluting TAXUS stents (PES) compared with overlapping bare-metal stents (BMS). Background: Increased paclitaxel dose in the PES-overlap region might be associated with arterial toxicity expressed as excessive expansive remodeling, incomplete stent apposition, or aneurysm formation. Methods: In the TAXUS-V and -VI trials, 51 patients with overlapping stents (27 PES and 24 BMS) were imaged with serial IVUS immediately after procedure and at 9 months. The IVUS measurements included intimal hyperplasia (IH), peri-stent plaque plus media (P&M), and external elastic membrane (EEM) areas. Vascular responses were assessed at the proximal and distal single stent strut regions and the central overlap region. Results: Compared with BMS, all 3 PES stent regions showed: 1) significantly decreased IH (proximal: 0.97 ± 1.06 mm2 vs. 3.12 ± 2.40 mm2, overlap: 0.74 ± 0.91 mm2 vs. 3.23 ± 1.75 mm2, distal: 0.88 ± 0.85 mm2 vs. 2.69 ± 1.49 mm2, all p < 0.05); and 2) increased P&M and EEM areas (Delta P&M; proximal: 0.96 ± 1.36 mm2 vs. -0.02 ± 1.48 mm2, overlap: 1.56 ± 1.88 mm2 vs. 0.29 ± 1.82 mm2, distal: 1.03 ± 1.81 mm2 vs. 0.11 ± 0.89 mm2, all p < 0.05). The IH and changes in EEM and P&M areas were not significantly different in both the BMS and PES groups comparing the single stent strut and overlap regions. Incomplete stent apposition did not occur at the site of overlapping PES in any patient. Conclusions: Nine months after stent implantation, neointimal tissue growth was reduced and expansive remodeling was greater with PES compared with BMS-effects that were not exaggerated at the overlap region of PES.
AB - Objectives: The purpose of this study was to use intravascular ultrasound (IVUS) to investigate chronic arterial responses at the site of and adjacent to overlapping paclitaxel-eluting TAXUS stents (PES) compared with overlapping bare-metal stents (BMS). Background: Increased paclitaxel dose in the PES-overlap region might be associated with arterial toxicity expressed as excessive expansive remodeling, incomplete stent apposition, or aneurysm formation. Methods: In the TAXUS-V and -VI trials, 51 patients with overlapping stents (27 PES and 24 BMS) were imaged with serial IVUS immediately after procedure and at 9 months. The IVUS measurements included intimal hyperplasia (IH), peri-stent plaque plus media (P&M), and external elastic membrane (EEM) areas. Vascular responses were assessed at the proximal and distal single stent strut regions and the central overlap region. Results: Compared with BMS, all 3 PES stent regions showed: 1) significantly decreased IH (proximal: 0.97 ± 1.06 mm2 vs. 3.12 ± 2.40 mm2, overlap: 0.74 ± 0.91 mm2 vs. 3.23 ± 1.75 mm2, distal: 0.88 ± 0.85 mm2 vs. 2.69 ± 1.49 mm2, all p < 0.05); and 2) increased P&M and EEM areas (Delta P&M; proximal: 0.96 ± 1.36 mm2 vs. -0.02 ± 1.48 mm2, overlap: 1.56 ± 1.88 mm2 vs. 0.29 ± 1.82 mm2, distal: 1.03 ± 1.81 mm2 vs. 0.11 ± 0.89 mm2, all p < 0.05). The IH and changes in EEM and P&M areas were not significantly different in both the BMS and PES groups comparing the single stent strut and overlap regions. Incomplete stent apposition did not occur at the site of overlapping PES in any patient. Conclusions: Nine months after stent implantation, neointimal tissue growth was reduced and expansive remodeling was greater with PES compared with BMS-effects that were not exaggerated at the overlap region of PES.
UR - https://www.scopus.com/pages/publications/41949131956
U2 - 10.1016/j.jcin.2007.12.005
DO - 10.1016/j.jcin.2007.12.005
M3 - Article
C2 - 19463294
AN - SCOPUS:41949131956
SN - 1936-8798
VL - 1
SP - 161
EP - 167
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 2
ER -