The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Serial comparison of neointimal hyperplasia between the thin strut MiStent with microcrystalline sirolimus and the durable polymer coated everolimus-eluting Xience stent: 6- and 24-month results of DESSOLVE III OCT sub-study

EuroIntervention 2019; just accepted article published in May 2019. DOI: 10.4244/EIJ-D-18-01201

1. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland. The Jerzy Kukuczka Academy of Physical Education, Faculty of Physiotherapy.; 2. Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands; 3. Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands; 4. Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands; 5. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland; 6. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland; 7. Department of Interventional Cardiology, ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands. First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland; 8. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland; 9. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland; 10. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland; 11. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland; 12. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland; 13. Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands; 14. The Lambe Institute for Translational Medicine and Curam, Saolta University Healthcare Group, National University of Ireland Galway, Ireland.; 15. Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands; 16. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Poland, Medical University of Silesia in Katowice, Poland.; 17. Department of Interventional Cardiology, ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands. Cardialysis, Rotterdam, the Netherlands; 18. Imperial College of London, London, United Kingdom, UNITED KINGDOM
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Aims: DESSOLVE III OCT sub-study compared serially neointimal hyperplasia volume obstruction (%VO) between the thin strut MiStent with early polymer elimination and 9-month sustained drug release from microcrystalline sirolimus and the durable polymer coated everolimus-eluting Xience stent at 6 and 24 months after implantation.

Methods and results: The efficacy endpoint was %VO calculated as abluminal neointimal volume/stent volume. Thirty-six patients (MiStent 16 patients, 16 lesions, Xience 20 patients, 22 lesions) underwent serial OCT evaluation at both 6 and 24 months. At 6 months, mean abluminal %VO was significantly lower in the MiStent group than in Xience group (14.54±3.70% vs. 19.11±6.70%; p=0.011), whereas the difference in %VO between the two groups decreased at 24 months (20.88±5.72% vs. 23.50±7.33%; p=0.24). There was no significant difference in percentage malapposed struts and percentage uncovered struts between the two groups at both time points.

Conclusions: In the serial comparative OCT analysis of the MiStent vs. the Xience, the MiStent showed a more favourable efficacy for preventing neointimal formation with comparable strut tissue coverage, as compared with the Xience at 6 months, but this difference in %VO decreased at 24 months so that the difference in neointima at 24 months was no longer significant.

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