Comparison of edge vascular response after sirolimus- and paclitaxel-eluting stent implantation

BackgroundTo compare the edges vascular response, we analyzed the intravascular ultrasound (IVUS) parameters after implantation of the sirolimus-eluting stent (SES) or the paclitaxel-eluting stent (PES).MethodsTwo hundred-two angina patients (123 men; 61.5 ± 9.2 years of age, SES: n = 91, PES: n = 111) were enrolled. Both edge segments of the stent were analyzed. The change (Δ) of each parameter at follow-up was calculated.ResultsThe edge restenosis rate was higher in the PES group. However, the Δ Vessel, Δ Plaque and Δ Lumen volume at 5 mm edge segments were not different between the two groups except the Δ Plaque volume at the distal segment, higher in the PES than the SES group (6.6 ± 15.7 vs. 1.0 ± 13.1 mm3, P = .016). In the PES group, lumen area at the both 1 mm edge segments decreased because of plaque progression (proximal, 1.9 ± 1.5 to 2.2 ± 2.0 mm2, P = .095; distal, 0.6 ± 1.1 to 1.0 ± 1.4 mm2, P = .018) with negative remodeling (proximal, 9.9 ± 2.4 to 9.4 ± 2.6 mm2, P = .004; distal, 7.6 ± 2.4 to 7.2 ± 2.4 mm2, P = .052). Conversely, lumen area at these segments increased due to plaque regression (proximal, 3.2 ± 1.8 to 2.1 ± 1.6 mm2, P = .000; distal, 1.5 ± 1.4 to 0.9 ± 1.3 mm2, P = .000) even though there was negative remodeling in the SES group (proximal, 10.1 ± 2.4 to 9.6 ± 2.3 mm2, P = .019; distal, 7.8 ± 2.3 to 7.5 ± 2.3 mm2, P = .074). The Δ Plaque and Δ Lumen area at the both 1 mm edge segments were more prominent in the PES group.ConclusionsCompared to SES, PES was associated with luminal reduction accompanied by plaque progression with negative remodeling at edge segments.