Coronary Heart Disease Clinical Trial
Official title:
Healing Response to Everolimus-eluting Stent Implantation; Serial Assessment With opticaL Coherence Tomography
The purpose of this study is to evaluate serial changes of neointimal coverage after everolimus-eluting stent implantation at 3-, 6- and 12-months by OCT examination.
Late and very late stent thrombosis is current main issue after introduction of drug-eluting
stents .Possible causes of these stent thromboses include thrombus formation resulting from
delayed neointimal coverage, spasms occurring at the distal end of the stent implantation
site, positive remodeling of coronary arteries caused by local immune reaction to paclitaxel
or rapamycin, and vascular endothelial damage induced by the polymer. For BMS, neointimal
coverage begins within the first one month after stent implantation and almost completes in
three months. For DES, sirolimus eluting stents (SES) for example, neointimal coverage is
markedly delayed after stent implantation and the exposed stent struts may be largely
attributable to the occurrence of late stent thrombosis.
On the other hand, everolimus eluting stents (EES), which have a thinner stent strut layer
and improved polymer biocompatibility, it has been reported that earlier and more normal
neointimal coverage can be achieved compared with other first-generation DESs, SES and
paclitaxel eluting stents (PES). These findings suggest that coverage with vascular
endothelium differs among different DES platforms. Optical coherence tomography (OCT) has a
resolution of 15 to 20 μm, which is approximately 10 times higher than that of intravascular
ultrasound (IVUS). It is therefore necessary to use OCT to accurately evaluate
cross-sectional images of the stent struts covered with vascular endothelium. However, no
studies have reported the results of continuous observation and evaluation of EES covered
with endothelium.
Therefore, the investigators investigate time course of neointimal coverage of EES through
detailed evaluation by OCT of neointimal coverage at 3, 6, and 12 months after stent
implantation.
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Observational Model: Cohort, Time Perspective: Prospective
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