The objective of this pilot study is to compare the PFS-eluting stent (ISAR Rapa G1) with the PPS-eluting stent (Cypher®) regarding uncovered stent strut segments at 5 years.
The mid-term efficacy of drug-eluting stents has been well-established, but there is an ongoing debate on the potential of an increased incidence of late stent thrombosis, particularly after discontinuation of thienopyridine therapy, as well as of delayed onset of restenosis or catch-up phenomenon with permanent polymer-based DES. The extent of strut coverage with reduction of exposed thrombogenic material has been shown to be associated with the inflammatory reaction grade and with the incidence of stent thrombosis. The optical coherence tomography (OCT) is an intravascular imaging modality based on light. The principle is similar to intravascular ultrasound, but due to the much shorter wave length of light, it offers a much better resolution up to 10µm, enabling the exact determination of strut coverage, neointimal thickness, vessel size, presence of dissections, and even the presence of inflammation. Patients who received a polymer-free or a permanent-polymer sirolimus-eluting stent about 5 years ago without in-segment intervention since, will be evaluated by OCT regarding the healing pattern and the late lumen loss of the stent.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
20
due randomization sirolimus-permanent-polymer eluting stent was implanted
due randomization sirolimus-polymer-free eluting stent was implanted
Deutsches Herzzentrum Muenchen
Munich, Bavaria, Germany
RECRUITINGKlinikum rechts der Isar
Munich, Bavaria, Germany
RECRUITINGDegree of stent strut coverage after 5 years assessed by OCT for each visible strut segment
Time frame: 5 years
Percentage of malapposed strut assessed by OCT
Time frame: 5 years
Percentage of uncovered malapposed struts assessed by OCT
Time frame: 5 years
Morphologic differences of neointima between stents
Time frame: 5 years
Late lumen loss at 5 years assessed by OCT
Time frame: 5 years
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