R. Hoffmann et al., Stent design related neointimal tissue proliferation in human coronary arteries - An intravascular ultrasound study, EUR HEART J, 22(21), 2001, pp. 2007-2014
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.