The International Journal of Cardiovascular Imaging

, Volume 29, Issue 6, pp 1229–1236

Comparison of neointimal hyperplasia and peri-stent vascular remodeling after implantation of everolimus-eluting versus sirolimus-eluting stents: intravascular ultrasound results from the EXCELLENT study

Authors

  • Young-Guk Ko
    • Division of Cardiology, Severance Cardiovascular HospitalYonsei University Health System
  • Dong-Ho Shin
    • Division of Cardiology, Severance Cardiovascular HospitalYonsei University Health System
  • Jung-Sun Kim
    • Division of Cardiology, Severance Cardiovascular HospitalYonsei University Health System
  • Byeong-Keuk Kim
    • Division of Cardiology, Severance Cardiovascular HospitalYonsei University Health System
  • Donghoon Choi
    • Division of Cardiology, Severance Cardiovascular HospitalYonsei University Health System
  • Myeong-Ki Hong
    • Division of Cardiology, Severance Cardiovascular HospitalYonsei University Health System
  • Hyeon-Cheol Gwon
    • Samsung Medical CenterSung-Kyun-Kwan University
  • Taehoon Ahn
    • Gil Medical CenterGachon University
  • In-Ho Chae
    • Seoul National University Bundang Hospital
  • Jung-Han Yoon
    • Wonju Severance HospitalYonsei University
  • Hyo-Soo Kim
    • Seoul National University Main Hospital
    • Division of Cardiology, Severance Cardiovascular HospitalYonsei University Health System
    • Severance Biomedical Science InstituteYonsei University Health System
  • EXCELLENT investigators
Original Paper

DOI: 10.1007/s10554-013-0199-5

Cite this article as:
Ko, Y., Shin, D., Kim, J. et al. Int J Cardiovasc Imaging (2013) 29: 1229. doi:10.1007/s10554-013-0199-5

Abstract

This study was designed to compare neointimal hyperplasia and peri-stent arterial remodeling after implantation of everolimus-eluting stent (EES) versus sirolimus-eluting stent (SES) using intravascular ultrasound (IVUS). The study population was a subgroup of 278 patients from the EXCELLENT trial, a randomized study comparing EES to SES in de novo coronary artery lesions (total n = 1,443, 3:1 randomization) who underwent post-PCI and 9-month follow-up IVUS evaluation. There were 209 patients in the EES group and 69 in the SES group. Baseline clinical and angiographic characteristics were similar between the two groups except for age and target lesion locations. At 9 months, percent neointimal volume obstruction did not differ between EES and SES (2.6 ± 4.0 % vs. 2.5 ± 4.8 %, p = 0.814). However, the relative change in the vessel (4.3 ± 13.7 % vs. 8.8 ± 18.6 %, p = 0.030) and plaque volume index (4.2 ± 17.4 % vs. 10.5 ± 22.3 %, p = 0.016) of the stented segment from post-intervention to follow-up was significantly less with EES than with SES. In addition, positive peri-stent vascular remodeling defined as an increase in vessel volume index >10 % (27.8 vs. 42.0 %, p = 0.027) and late acquired stent malapposition (LASM, 1.9 vs. 15.9 %, p < 0.001) were observed less frequently with EES than SES. EES and SES were similarly effective in reducing neointimal hyperplasia. However, positive peri-stent vascular remodeling and LASM occurred less frequently with EES than SES.

Keywords

Drug-eluting stentIntravascular ultrasoundNeointimal hyperplasiaVascular remodeling

Copyright information

© Springer Science+Business Media Dordrecht 2013