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Late vascular response at the edges of sirolimus analogous‐eluting stents in diabetic patients: An intravascular ultrasound study
Author(s) -
Lasave Leandro I.,
Abizaid Alexandre A.C.,
de Ribamar Costa José,
Tanajura Luiz F.,
Feres Fausto,
Abizaid Andrea S.,
Siqueira Dimytri,
Staico Rodolfo,
Sousa Amanda GRM,
Sousa J. Eduardo
Publication year - 2007
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21139
Subject(s) - medicine , intravascular ultrasound , restenosis , sirolimus , diabetes mellitus , stent , lumen (anatomy) , lesion , cardiology , zotarolimus , radiology , drug eluting stent , surgery , endocrinology
: Vascular response at edges of drug‐eluting stents is still not well established, particularly in diabetic patients who are prone to aggressive atherosclerosis progression. Recently, Biolimus and Zotarolimus have demonstrated potent antiproliferative effects. Objective : To compare the vascular responses at edges of sirolimus analogous‐eluting stents in patients with and without diabetes, using intravascular ultrasound (IVUS). Methods : 306 edges were analyzed in 153 patients treated with drug‐eluting stents and divided in: diabetics (122 edges) and nondiabetics (166 edges). IVUS was performed postintervention and at 6‐month follow‐up and included 5 mm distal and proximal to the stented segment. Vessel, lumen, and plaque volumes were calculated. Volume variation (follow‐up minus basal) was also calculated. Edge restenosis was defined as obstruction >50%. Results : Baseline characteristics were similar between groups. In both groups the entire lesion length was covered (stent length/lesion length ratio was 1.5 for both groups). There were no differences in edge volumes and restenosis rate between the groups. Among diabetics, there was no significant volume variation. However, in nondiabetic patients there was significant increase in vessel volume in proximal (from 67.1 ± 22 mm 3 to 72.2 ± 25 mm 3 : P = 0.02) and distal (from 54.4 ± 22 mm 3 to 59.8 ± 22 mm 3 : P = 0.001) edges. Conclusion : Nondiabetic patients showed a significant positive vascular remodeling in proximal and distal edges of sirolimus analogous‐eluting stent. This vascular mechanism was not observed in diabetic patients. Although different vascular responses were observed, restenosis rates were equivalent between the 2 groups at 6‐month follow‐up. © 2007 Wiley‐Liss, Inc.