Arquivos Brasileiros de Cardiologia (Apr 2006)

Análise comparativa da hiperplasia intimal após o implante de stents com e sem sirolimus em artérias coronárias de pequeno calibre Comparative analysis of intimal hyperplasia after sirolimus-eluting stent and thin-strut bare-metal stent implantation in small coronary arteries

  • Fernando Stuchi Devito,
  • Amanda G. M. R. Sousa,
  • Fausto Feres,
  • Alexandre Antonio Cunha Abizaid,
  • Rodolfo Staico,
  • Luis Alberto Piva Mattos,
  • Luis Fernando Leite Tanajura,
  • Andréa C. L. S. Abizaid,
  • Áurea Jacob Chaves,
  • J. Eduardo M. R. Sousa

DOI
https://doi.org/10.1590/S0066-782X2006000400006
Journal volume & issue
Vol. 86, no. 4
pp. 268 – 275

Abstract

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OBJETIVO: Avaliar a redução do volume de hiperplasia intimal após angioplastia com stents com sirolimus (Cypher®) comparados com os stents não-recobertos de estrutura metálica fina (Pixel®) em pacientes com vasos pequenos. MÉTODOS: Oitenta pacientes com doença arterial coronariana foram prospectivamente incluídos em duas séries consecutivas de tratamento, sendo a primeira empregando stents com sirolimus (50) e a segunda stents não-recobertos de estrutura metálica fina (30). RESULTADOS: Os resultados foram: menor porcentual de obstrução da prótese através do ultra-som intracoronário [5,0% (EP = 0,77) x 39,0% (EP = 4,72), p OBJECTIVE: This study aimed at evaluating reduction in intimal hyperplasia volume following angioplasty using sirolimus-eluting stents (Cypher™) compared with thin-strut bare-metal stents (Pixel™) in patients with small vessels. METHODS: Eighty patients with coronary artery disease were prospectively included in two consecutive series, the first using sirolimus-eluting stents (50) and the second using bare-metal stents (30). RESULTS: The use of sirolimus-eluting stents reduced: in-stent net volume obstruction [5.0% (SE = 0.77) x 39.0% (SE = 4.72), p < 0.001], in-stent late loss [0.25 mm (SE = 0.03) x 1,11 mm (SE = 0.13), p < 0,001], in-segment late loss [0.30 mm (SE = 0.04) x 0.83 mm (SE = 0.11), p < 0.001], in-stent restenosis (0% x 33.3%, p < 0.001) and in-segment restenosis (4% x 36.7%, p < 0.001). The event-free survival rate was 96% in the sirolimus-eluting stent group versus 86.7% in the bare-metal stent group (BMS) (p = 0.190). CONCLUSION: Sirolimus-eluting stents are superior to thin-strut bare-metal stents in reducing intimal hyperplasia (less in-stent obstruction and less late lumen loss) in patients with small vessels. The use of these stents significantly reduced angiographic restenosis at eight months.

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