Early vascular healing following bioresorbable-polymer sirolimus-eluting stent implantation in comparison with durable-polymer everolimus-eluting stent: sequential optical coherence tomography study

Abstract

Background: Orsiro ultrathin‐strut bioresorbable‐polymer sirolimus‐eluting stent (BP‐SES) might facilitate early vascular healing responses that seems to be associated with improved long‐term clinical outcomes. We compared the early vascular healing responses to BP‐SES and Xience durable‐polymer everolimus‐eluting stent (DP‐EES) in patients with chronic coronary syndrome (CCS) using optical coherence tomography (OCT). Methods: A total of 40 patients with CCS receiving OCT‐guided PCI were included. 20 patients were assigned to BP‐SES, and 20 to DP‐EES. OCT was performed immediately after stent placement (post‐procedure) and at 1 month follow‐up. Struts were recorded as uncovered if any part was visibly exposed in the lumen or covered if a layer of tissue covered all reflecting surfaces. The incidence of intrastent thrombus (IS‐Th) and irregular protrusion (IRP) were also assessed. Results: At 1 month, the percentage of uncovered struts was significantly lower in the BP‐SES compared with the DP‐EES (2.8±1.6% vs. 5.8±1.8%, respectively; p<0.001), and that of malapposed struts was similar between both groups (2.5±3.1% vs. 2.4±2.2%; p=0.76). There were no differences in the incidence of IS‐Th (65.0% vs. 55.0% at post‐procedure; p=0.54, 30.0% vs. 35.0% at 1 month; p=0.75) and IRP (30.0% vs. 25.0% at post‐procedure; p=0.74). IRP had completely resolved at 1 month in both groups. Conclusion: Early vascular healing response to Orsiro BP‐SES implantation was revealed in CCS patients at 1 month compared with Xience DPEES. Orsiro BP‐SES may have a potential to shorten the dual antiplatelet therapy duration.