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 Feb 19;16(14):1187-1194. doi: 10.4244/EIJ-D-18-01201.

Abstract

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.

MeSH terms

  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / therapy
  • Drug-Eluting Stents*
  • Everolimus / therapeutic use
  • Humans
  • Hyperplasia
  • Neointima
  • Percutaneous Coronary Intervention* / adverse effects
  • Polymers
  • Prosthesis Design
  • Sirolimus / therapeutic use
  • Stents
  • Tomography, Optical Coherence
  • Treatment Outcome

Substances

  • Polymers
  • Everolimus
  • Sirolimus