First-in-Man Evaluation of a Sirolimus-Eluting Stent With Abluminal Fluoropolymeric/Triflusal Coating With Ultrathin Struts by OCT at 9 Months' Follow-Up: The PROMETHEUS Study

Cardiovasc Revasc Med. 2021 Nov:32:18-24. doi: 10.1016/j.carrev.2020.12.025. Epub 2020 Dec 29.

Abstract

Objectives: We sought to investigate stent healing and neointimal hyperplasia with ihtDEStiny drug-eluting stent (DES) by optical coherence tomography (OCT) examination conducted 9 months after implantation.

Background: The currently used DES present certain features that have been linked separately to their better performance in terms of efficacy and safety.

Methods: First-in-man, prospective and multicenter study including patients treated with ihtDEStiny stent undergoing OCT examination at 9 months follow up. The ihtDEStiny stent is a sirolimus eluting stent with an oval shape ultrathin struts (68 μm) and an abluminal coating of a fluoropolymer containing the antiplatelet agent triflusal. Primary endpoint was the percentage of obstruction of the in-stent volume by the neointima.

Results: In 58 patients (63 lesions) in-stent late lumen loss was 0.11 ± 0.23 mm (95% CI 0.05-0.16) with only in 6% of stents being > 0.5 mm and in-segment binary stenosis was 1.6%. In OCT mean neointima volume obstruction was 10.5 ± 6.9% with a mean neointima thickness of 110.9 ± 89.8 μm. The proportion of uncovered struts was 2.5%, malapposed struts 1.1% and malapposed/uncovered struts 0.7% and no subclinical thrombi detected. Mean incomplete stent apposition area was 0.1 ± 0.1 mm2. At 12 months target lesion revascularization rate was 3% and no stent thrombosis was reported.

Conclusions: In this study the ihtDEStiny stent has shown a very low degree of neointimal proliferation associated with a low rate of uncovered/malapposed struts and total absence of subclinical thrombi at 9 months follow up.

Keywords: Drug-eluting stent; Optical coherence tomography; Restenosis; Vascular healing.

Publication types

  • Multicenter Study

MeSH terms

  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / surgery
  • Drug-Eluting Stents*
  • Humans
  • Neointima
  • Percutaneous Coronary Intervention* / adverse effects
  • Prospective Studies
  • Salicylates
  • Sirolimus / adverse effects
  • Stents
  • Tomography, Optical Coherence
  • Treatment Outcome

Substances

  • Salicylates
  • triflusal
  • Sirolimus