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New type of sirolimus-eluting stent demonstrates superior results
Date:9/21/2009

loaded. The stent's design achieves both a significant reduction in total polymer load as well as a reduction in tissue-polymer contact by more than 75% compared to conventional DES in which the entire stent surface is coated with polymer. Its use of a bioresorbable polymer is another theoretical advantage from the safety perspective, allowing the drug-eluting stent to become simple bare metal within the vessel wall approximately 3 months after deployment.

In this clinical trial, detailed arterial responses to the new DES technology were also investigated in vivo using intravascular ultrasound (IVUS). With IVUS, a tiny catheter is inserted into a coronary vessel where high-frequency sound waves reflect off tissue or vessel walls. The reflected waves create a cross-sectional image from within the vessel to aid in visualizing its structure, thereby providing both quantitative and qualitative information on vessel reaction after stenting.

Serial IVUS (immediately post-stenting and 6-month follow-up) was performed in a pre-defined IVUS subset of 100 patients (52 SES in 50 patients; 52 PES in 50 patients). Volumetric IVUS analysis demonstrated significantly less neointimal proliferation in the sirolimus-eluting stent (% neointimal volume: 5.511.0 vs. 11.59.7, p=0.016), resulting in less late lumen area loss and smaller maximum cross-sectional narrowing (neointimal area/stent area) than PES. In addition, serial IVUS analysis revealed significantly less outward vessel remodeling in the SES than in PES. The incidence of late-acquired incomplete stent apposition (ISA) was similar between the SES and PES. However, SES was associated with less outward vessel remodeling at the ISA segment, possibly suggesting different underlying mechanisms of this phenomenon.

"Our study is the first report investigating the detailed arterial responses to this new DES technology, with a randomized, blinded comparison of sirolimus-eluting stents with paclitaxel-elut
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Contact: Judy Romero
jromero@crf.org
347-407-2774
Cardiovascular Research Foundation
Source:Eurekalert

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