Serial Assessment of Strut Coverage of Biodegradable Polymer Drug-Eluting Stent at 1, 2, and 3 Months After Stent Implantation by Optical Frequency Domain Imaging: The DISCOVERY 1TO3 Study (Evaluation With OFDI of Strut Coverage of Terumo New Drug Eluting Stent With Biodegradable Polymer at 1, 2, and 3 Months)

Circ Cardiovasc Interv. 2017 Dec;10(12):e004801. doi: 10.1161/CIRCINTERVENTIONS.116.004801.

Abstract

Background: To assess the vessel-healing pattern of Ultimaster drug-eluting stent using optical frequency domain imaging. Our hypothesis is that biodegradable polymer-based drug-eluting technology allows complete very early strut coverage.

Methods and results: The DISCOVERY 1TO3 study (Evaluation With OFDI of Strut Coverage of Terumo New Drug Eluting Stent With Biodegradable Polymer at 1, 2, and 3 Months) is a prospective, single-arm, multicenter study. A total of 60 patients with multivessel disease requiring staged procedure at 1 month were treated with Ultimaster. Optical frequency domain imaging was acquired at baseline, 1, 2, and 3 months. The primary end point is optical frequency domain imaging-assessed strut coverage at 3 months. Mean age of patients was 67.2±9.9 years, and 73.3% were male, and 36.7% presented with acute coronary syndrome. A total of 132 lesions were treated, with average 1.4 lesions per patient treated at baseline and 1.1 lesions treated at 1 month. Strut coverage at 3 months of single implanted stents (n=71, primary end point) was 95.2±5.2% and of combined single and overlapped stents was 95.4±4.9%. Strut coverage of combined single and overlapped stents at 1 (n=49) and 2 months (n=38) was 85.1±12.7% and 87.9±10.8%, respectively. The median neointimal hyperplasia thickness was 0.04, 0.05, and 0.06 mm, whereas mean neointimal hyperplasia obstruction was 4.5±2.4%, 5.2±3.4%, and 6.6±3.3% at 1, 2, and 3 months, respectively.

Conclusions: Nearly complete strut coverage was observed in this complex population very early after implantation of Ultimaster drug-eluting stent.

Clinical trial registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01844843.

Keywords: coronary artery disease; drug-eluting stents; hyperplasia; neointima; percutaneous coronary intervention.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Absorbable Implants*
  • Aged
  • Cardiovascular Agents / administration & dosage*
  • Cardiovascular Agents / adverse effects
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / therapy*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / drug effects*
  • Drug-Eluting Stents*
  • Europe
  • Female
  • Humans
  • Hyperplasia
  • Male
  • Middle Aged
  • Neointima
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Polyesters / chemistry*
  • Predictive Value of Tests
  • Prospective Studies
  • Prosthesis Design
  • Risk Factors
  • Sirolimus / administration & dosage*
  • Sirolimus / adverse effects
  • Time Factors
  • Tomography, Optical Coherence*
  • Treatment Outcome
  • Wound Healing / drug effects

Substances

  • Cardiovascular Agents
  • Polyesters
  • lactide-caprolactone copolymer
  • Sirolimus

Associated data

  • ClinicalTrials.gov/NCT01844843