The relationship between re-endothelialization and endothelial function after DES implantation: comparison between paclitaxcel eluting stent and zotarolims eluting stent

Catheter Cardiovasc Interv. 2014 Feb 15;83(3):412-7. doi: 10.1002/ccd.25140.

Abstract

Background: Several studies have reported re-endothelialization and endothelial function after drug-eluting stent (DES) implantation; however, the relationship between re-endothelialization and endothelial function after DES implantation has not been investigated yet.

Methods: A total of 14 patients underwent evaluation of re-endothelialization by optical coherence tomography (OCT) and endothelial function by incremental Ach infusion at 9 months after DES implantation (ZES: N = 7, PES: N = 7). The neointimal thickness (NIT) inside each strut, strut coverage, and malapposition at every 1 mm cross-section were evaluated by OCT and the endothelial function was estimated by measuring the coronary vaso-reactivity in response to acetylcholine (Ach) infusion into coronary arteries.

Results: Zotarolims eluting stent (ZES), compared with paclitaxcel eluting stent (PES), showed more homogeneous neointimal coverage of stent struts and low rate of malapposition. Vasoconstriction in response to Ach in the peri-stent region was also less pronounced in ZES than PES. In particular, vasoconstriction was more often observed in cases with inhomogeneous neointimal coverage of stent struts in the PES group.

Conclusions: Our findings suggest that endothelial function seems to be better preserved with ZES than PES, and homogeneous neointimal coverage of stent struts seem to be associated with the preserved endothelial function.

Publication types

  • Comparative Study

MeSH terms

  • Acetylcholine / administration & dosage
  • Aged
  • Cardiovascular Agents / administration & dosage*
  • Coronary Angiography
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / therapy*
  • Coronary Vessels / drug effects*
  • Coronary Vessels / pathology
  • Coronary Vessels / physiopathology
  • Drug-Eluting Stents*
  • Endothelial Cells / drug effects*
  • Endothelial Cells / pathology
  • Female
  • Humans
  • Infusions, Intra-Arterial
  • Male
  • Middle Aged
  • Neointima
  • Paclitaxel / administration & dosage*
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Prosthesis Design
  • Re-Epithelialization / drug effects*
  • Retrospective Studies
  • Sirolimus / administration & dosage
  • Sirolimus / analogs & derivatives*
  • Time Factors
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vasoconstriction / drug effects
  • Vasoconstrictor Agents / administration & dosage

Substances

  • Cardiovascular Agents
  • Vasoconstrictor Agents
  • zotarolimus
  • Acetylcholine
  • Paclitaxel
  • Sirolimus