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Coronary interventions

Neointimal hyperplasia of ultra-thin stents with microcrystalline sirolimus or durable polymer everolimus-eluting stents: 6- and 24-month results of the DESSOLVE III OCT study

EuroIntervention 2021;16:1187-1194. DOI: 10.4244/EIJ-D-18-01201

1. Center for Cardiovascular Research and Development, American Heart of Poland, Katowice, Ustron, Poland; 2. The Jerzy Kukuczka Academy of Physical Education, Faculty of Physiotherapy, Katowice, Poland; 3. Department of Cardiology, Academic Medical Center, Amsterdam, the Netherlands; 4. Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands; 5. First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland; 6. The Lambe Institute for Translational Medicine and Curam, Saolta University Healthcare Group, National University of Ireland Galway, Galway, Ireland; 7. Medical University of Silesia in Katowice, Katowice, Poland; 8. Cardialysis, Rotterdam, the Netherlands; 9. Department of Cardiology, National University of Ireland Galway (NUIG), Galway, Ireland

Aims: The DESSOLVE III OCT substudy aimed to compare serially neointimal hyperplasia volume obstruction (%VO) between the thin-strut MiStent with early polymer elimination and nine-month sustained drug release from microcrystalline sirolimus and the durable polymer-coated everolimus-eluting XIENCE stent at six 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 six and 24 months. At six months, mean abluminal %VO was significantly lower in the MiStent group than in the 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 versus the XIENCE, the MiStent showed a more favourable efficacy for preventing neointimal formation with comparable strut tissue coverage, as compared with the XIENCE at six 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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