Stent design related neointimal tissue proliferation in human coronary arteries - An intravascular ultrasound study

Aims Histological restenosis models in animals have indicated that stent de sign has a significant impact on vessel trauma during stent implantation an d on the amount of subsequent neointimal tissue proliferation. The impact o f different stent designs on intimal hyperplasia in human atherosclerotic c oronary arteries has not been determined. Methods and Results Angiographic and intravascular ultrasound studies were performed at the 6 month follow-up in 131 consecutive native coronary lesio ns of 131 patients treated with 50 Multi-Link (TM) stents, 40 InFlow (TM) s tents and 41 Palmaz-Schatz (TM) stents. Lumen and stent cross-sectional are as (CSA) were measured at I mm axial increments. Mean intimal hyperplasia c ross-sectional area (stent CSA - lumen CSA) and mean intimal hyperplasia th ickness were calculated. Intravascular ultrasound demonstrated different le vels of intimal. hyperplasia proliferation for the three stents. Mean intim al hyperplasia thickness was 0.16 +/- 0.08 mm for Multi-Link stents, 0.26 /- 0.19 mm for Palmaz-Schatz stents and 0.39 +/- 0.14 mm for Inflow stents (P <0.001). Multivariate analysis proved that stent type was the only indep endent predictor of intimal hyperplasia thickness at follow-Lip (P <0.001). Conclusion Coronary stent design has a significant impact on subsequent int imal hyperplasia after implantation into atherosclerotic human coronary art eries. The corrugated ring design of the Multi-Link stent proved to result in less tissue proliferation at 6-month follow-up than the tubular slotted design of Palmaz-Schatz and InFlow stents. (C) 2001 The European Society of Cardiology.