1. Early Vascular Response to Ultrathin Biodegradable Polymer Sirolimus-Eluting Stents for the Treatment of ST-Elevation Myocardial Infarction After Plaque Rupture
- Author
-
Syunya Sato, Koshiro Sakai, Taito Arai, Hiroyoshi Mori, Hidenari Matsumoto, Ryota Masaki, Hiroaki Tsujita, Naoki Matsukawa, Ryota Kosaki, Ken Arai, Kohei Wakabayashi, Kunihiro Ogura, Yosuke Oishi, Shigeto Tsukamoto, Teruo Sekimoto, Hiroshi Suzuki, Toshiro Shinke, Seita Kondo, Hideaki Tanaka, Rikuo Sakai, Masahiko Ochiai, Myong Hwa Yamamoto, and Kosuke Nomura
- Subjects
Male ,medicine.medical_specialty ,Acute coronary syndrome ,medicine.medical_treatment ,Lumen (anatomy) ,Pilot Projects ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Coronary Circulation ,Internal medicine ,medicine ,Humans ,Prospective Studies ,cardiovascular diseases ,030212 general & internal medicine ,Myocardial infarction ,Aged ,Sirolimus ,Antibiotics, Antineoplastic ,medicine.diagnostic_test ,business.industry ,Percutaneous coronary intervention ,Stent ,Drug-Eluting Stents ,General Medicine ,Middle Aged ,equipment and supplies ,medicine.disease ,Coronary Vessels ,Apposition ,Treatment Outcome ,surgical procedures, operative ,Angiography ,Conventional PCI ,Cardiology ,ST Elevation Myocardial Infarction ,Female ,Cardiology and Cardiovascular Medicine ,business ,Tomography, Optical Coherence - Abstract
Recent clinical studies suggest that newer-generation drug-eluting stents that combine ultrathin struts and nanocoating (biodegradable polymer sirolimus-eluting stents, BP-SES) could improve long-term clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). However, the early vascular response to BP-SES in these patients has not been investigated so far.We examined this response in 20 patients with STEMI caused by plaque rupture using frequency-domain optical coherence tomography (OCT) to understand the underlying mechanisms. Plaque rupture was diagnosed by OCT before PCI with BP-SES implantation was performed. OCT was again performed before the final angiography (post-PCI) and after 2 weeks (2W-OCT).BP-SES placement caused protrusion of atherothrombotic material into the stent lumen and incomplete stent apposition in all patients. After 2 weeks, incomplete stent apposition was significantly reduced (% malapposed struts: post-PCI 4.7 ± 3.3%; 2W-OCT 0.9 ± 1.2%; P < 0.0001), and the percentage of uncovered struts also significantly decreased (% uncovered struts: post-PCI; 69.8 ± 18.3%: 2W-OCT; 29.6 ± 11.0%, P < 0.0001). The maximum protrusion area of the atherothrombotic burden was significantly reduced (post-PCI 1.36 ± 0.70 mm2; 2W-OCT 0.98 ± 0.55 mm2; P = 0.004).This study on the early vascular responses following BP-SES implantation showed rapid resolution of atherothrombotic material and progression of strut apposition and coverage. (UMIN000041324).
- Published
- 2021