4.6 Article

Evaluation in 3 Months Duration of Neointimal Coverage After Zotarolimus-Eluting Stent Implantation by Optical Coherence Tomography The ENDEAVOR OCT Trial

Journal

JACC-CARDIOVASCULAR INTERVENTIONS
Volume 2, Issue 12, Pages 1240-1247

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jcin.2009.10.006

Keywords

drug-eluting stent; optical coherence; tomography; zotarolimus

Funding

  1. Project Ministry for Health, Welfare & Family Affairs, Republic of Korea [A085012, A000385]
  2. Ministry of Health & Welfare, Republic of Korea [A085136]
  3. Cardiovascular Research Center, Seoul, Korea

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Objectives We performed this study to investigate the vascular response in early period after zortarolimus-eluting stent (ZES) (Endeavor Sprint, Medtronic CardioVascular, Minneapolis, Minnesota) implantation. Background The ZES has different characteristics, with biocompatible polymer and rapid drug-elution, compared with the first-generation drug-eluting stents (DES). Methods The ENDEAVOR OCT (Evaluation in 3 Months Duration of Neointimal Coverage after Zotarolimus-Eluting Stent Implantation by Optical Coherence Tomography) trial is a prospective, single-center study evaluating vascular healing patterns with optical coherence tomography (OCT) at 3 months after stent implantation. A total of 31 ZES in 30 patients underwent serial OCT at immediate post-intervention and 3 months. Neointimal growth and malapposition were analyzed at each stent strut of cross-sectional OCT images with 0.5-mm intervals. Results The incidence of malapposition at post-intervention and 3 months was 6.0% and 0.2%, respectively. However, late acquired malapposition was not detected at 3 months. Of 31 stents, 27 stents (87.1%) were covered completely with neointima, but the remaining 4 stents had 2 (0.8%), 4 (0.9%), 4 (1.2%), and 6 (1.4%) uncovered struts. Overall mean percentage of covered stent struts was 99.9 +/- 0.4%. This finding was consistent among groups with acute coronary syndrome and stable angina pectoris (99.9 +/- 0.3% vs. 99.9 +/- 0.4%, p = 0.92). Intracoronary thrombus was documented in 1 stent (3.2%) among 31 stents. Conclusions Most of the stent struts were covered with neointima, and late acquired malapposition was not found at 3 months after ZES implantation. Therefore, the current study demonstrated that ZES might have a favorable in vivo vascular response at 3 months after stent implantation. (Evaluation of Zotarolimus Eluting Stent at 3 Months Using Optical Coherence Tomography (ENDEAVOR OCT]; NCT00815139) (J Am Coll Cardiol Intv 2009;2:1240-7) (C) 2009 by the American College of Cardiology Foundation

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