Stent design related neointimal tissue proliferation in human coronary arteries; an intravascular ultrasound study

Abstract

Aims Histological restenosis models in animals have indicated that stent design has a significant impact on vessel trauma during stent implantation and on the amount of subsequent neointimal tissue proliferation. The impact of different stent designs on intimal hyperplasia in human atherosclerotic coronary arteries has not been determined. Methods and Results Angiographic and intravascular ultrasound studies were performed at the 6 month follow-up in 131 consecutive native coronary lesions of 131 patients treated with 50 Multi-Link™ stents, 40 InFlow™ stents and 41 Palmaz–Schatz™ stents. Lumen and stent cross-sectional areas (CSA) were measured at 1mm axial increments. Mean intimal hyperplasia cross-sectional area (stent CSA−lumen CSA) and mean intimal hyperplasia thickness were calculated. Intravascular ultrasound demonstrated different levels of intimal hyperplasia proliferation for the three stents. Mean intimal hyperplasia thickness was 0·16±0·08mm for Multi-Link stents, 0·26±0·19mm for Palmaz–Schatz stents and 0·39±0·14mm for Inflow stents (PPConclusion Coronary stent design has a significant impact on subsequent intimal hyperplasia after implantation into atherosclerotic human coronary arteries. The corrugated ring design of the Multi-Link stent proved to result in less tissue proliferation at 6-month follow-up than the tubular slotted design of Palmaz–Schatz and InFlow stents.