血管镜观察药物洗脱支架置入后支架表面内膜覆盖.ppt

Movies of the representative cases are presented here. The left side movie shows internal surface of the BMS 2.7 months after implantation, and the right side reveals that of the SES 3.7 months after implantation. As you can easy recognize, the BMS struts were fully embedded by the neointima and invisible as demonstrated in the left panel. In contrast, as shown in the right panel, the SES was not embedded by the neointima. * This case was implated both BMS and SES in hybrid manner. Bx velocity implanted disatal LAD and Cyhper proximally. Agiogram reveled markedly different neointima growth. Neointima over the BMS was Grade 3, otherwise SES was Grade 0. * To determine the chronological changes beyond 1 year after the SES implantation, we performed angioscopic observation in the same patients at 4 months, 1 year, and 2 years after stent implantation. Light blue dot indicates the SES. At the first follow-up, about 80% of SES showed grade 1 coverage. And neointimal coverage grade remained unchanged for one year. About 70% of SES showed grade 1 coverage even at 2 years after implantation, although three SES showed improvement of neointima coverage grade by one grade. * We also investigated angioscopic findings of PES in 30 patients. This slide shows the case implanted SES and PES at the same time. At 8 months, SES showed grade 1 coverage throughout the stent. The proximal to mid portion of PES showed grade 2 coverage. However, distal site of PES showed grade 0 with red thrombus adhesion. Like this case, PES showed higher neointimal coverage than SES in some parts, whereas the heterogeneous coverage that hampered the sealing yellow plaques and stent struts is very common. * Now for angioscopic results. This slide shows the distribution of the dominant neointimal coverage grades.. Blue bars represent sirolimus-eluting stents, and red bars, paclitaxel-eluting stents. More than 70% of SES showed grade 1 coverage. In contrast, approximately 40% of PES showed grade