Comparing the vascular response in implantation of self-expanding, bare metal nitinol stents or paclitaxel-eluting nitinol stents in superficial femoral artery lesions: a serial optical frequency domain imaging study

作者：Miki Kojiro; Fujii Kenichi^*; Shibuya Masahiko; Fukunaga Masashi; Imanaka Takahiro; Tamaru Hiroto; Nishimura Machiko; Horimatsu Tetsuo; Honda Yasuhiro; Fitzgerald Peter J; Masuyama Tohru; Ishihara Masaharu

来源：Eurointervention, 2016, 12(12): 1551-1558.

DOI：10.4244/EIJ-D-15-00399

• drug-eluting stent
• endovascular therapy
• optical frequency domain imaging
• peripheral artery disease
• superficial femoral artery

Aims: This study sought to investigate differences in vascular response between self-expanding bare metal nitinol stents (BMS) and paclitaxel-eluting nitinol stents (PES), in superficial femoral artery (SFA) disease, using optical frequency domain imaging (OFDI).
Methods and results: Six months after stent implantation, follow-up quantitative vascular angiography (QVA) and OFDI assessment were scheduled to evaluate vascular response. Volume index (VI) was defined as volume divided by stent length. The primary endpoint was OFDI-derived late lumen area loss, defined as lumen VI post stent implantation minus lumen VI at follow-up. A total of 28 SFA lesions were analysed, with cases randomised to receive either BMS or PES implantation. QVA-derived diameter stenosis at sixmonth follow-up was lower in the PES group than in the BMS group (28.5% vs. 39.7%, p=0.04). After six months, BMS VI increased by 33.8% (20.7 +/- 3.7 to 27.7 +/- 3.5 mm(3)/mm), whilst PES exhibited an increase of 32.1% (19.0 +/- 2.3 to 25.1 +/- 4.7 mm(3)/mm). Neointimal VI was smaller (7.4 +/- 2.6 mm(3)/mm vs. 10.5 +/- 3.2 mm(3)/mm, p< 0.01) and late lumen area loss was lower (2.9 +/- 1.3 mm(3)/mm vs. 5.6 +/- 2.8 mm(3)/mm, p< 0.01) in the PES group.
Conclusions: Serial volumetric OFDI analyses confirmed significantly smaller amounts of neointimal tissue and lower late lumen area loss following PES implantation for SFA lesions at short-term follow-up.

• 出版日期2016-12