Vascular Response After Zilver PTX Stent Implantation for Superficial Femoral Artery Lesions: Serial Optical Coherence Tomography Findings at 6 and 12 Months. (February 2015)

• Record Type: Journal Article
• Authors: Tomoi, Yusuke; Kuramitsu, Shoichi; Soga, Yoshimitsu; Aihara, Hideaki; Ando, Kenji; Nobuyoshi, Masakiyo
• Is Part Of: Journal of endovascular therapy. Volume 22:Number 1(2015:Feb.)
• Page Start: 41
• Page End: 47
• Publication Date: 2015-02
• Subjects: drug-eluting stent -- optical coherence tomography -- endovascular therapy -- superficial femoral artery -- vascular response -- neointimal thickness -- stent apposition -- neovascularization -- inflammation; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602814566577
• Languages: English
• ISSNs: 1526-6028

Abstract

Purpose: To compare the vascular response after paclitaxel-coated nitinol drug-eluting stent (Zilver PTX) implantation for superficial femoral artery lesions after 6 and 12 months using optical coherence tomography (OCT).Methods: Serial OCT examinations were performed in 5 patients (4 men; mean age 78.4±6.8 years) with 9 Zilver PTX stents at 6- and 12-month follow-up. Variables evaluated included neointimal thickness and apposition on each strut, the incidence of extrastent lumen (ESL), peristrut low-intensity area (PLIA), and neovascularization at 1-mm intervals.Results: A total of 249 matched cross-section images were evaluated and included 4788 and 4826 struts at 6 and 12 months, respectively. Mean neointimal thickness significantly increased from 480 to 540 µm between 6 and 12 months (p<0.001). The percentage of uncovered struts tended to decrease at 12 months (3% vs. 2.3%, p=0.054), whereas the percentage of malapposed struts were similar at both examinations (0.2% vs. 0.2%, p>0.99). Although the incidence of ESL in cross sections was not different (35% vs. 31%, p=0.29), median ESL area significantly increased from 6 to 12 months [0.12 (0.04–0.36) vs. 0.31 (0.14–0.59) mm 2, p=0.003)]. The presence of PLIA (29% vs. 44%, p<0.001) and neovascularization (14% vs. 27%, p<0.001) increased from 6 to 12 months.Conclusion: These findings suggest that delayed vascular healing and persistent peristent inflammation may be present even at 12 months after Zilver PTX implantation.