Angioscopic Assessments at 3 Months After Fluoropolymer-Based Paclitaxel-Eluting Stent Implantation for Femoropopliteal Endovascular Intervention

• Published in: Circulation Journal Vol. 84; no. 11; pp. 1999 - 2005
• Main Authors: Tsujimura, Takuya, Ishihara, Takayuki, Iida, Osamu, Hata, Yosuke, Kurata, Naoya, Asai, Mitsutoshi, Masuda, Masaharu, Okamoto, Shin, Nanto, Kiyonori, Kanda, Takashi, Matsuda, Yasuhiro, Mano, Toshiaki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 23.10.2020
• Subjects: Angioscopy; Coronary Vessels; Drug-Eluting Stents; Endovascular therapy; Femoral Artery; Humans; Neointima - diagnostic imaging; Paclitaxel - therapeutic use; Peripheral artery disease; Popliteal Artery; Treatment Outcome; Peripheral artery disease; Angioscopy; Endovascular therapy; Drug-eluting stents
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-20-0551

Background:The detailed mechanism of early-phase arterial healing after novel fluoropolymer-based paclitaxel-eluting stent (PES) implantation in the femoropopliteal (FP) lesions has not been elucidated.Methods and Results:We evaluated the intravascular status of 20 PES implanted in 11 FP lesions of 9 patients using angioscopy at approximately 3 months after implantation. Angioscopic images were analyzed to determine (1) the dominant degree of neointimal coverage (NIC) over the stent; (2) the extent of uncovered struts; and (3) the presence of intrastent thrombus. NIC was classified into 4 grades: grade 0, stent struts fully visible; grade 1, stent struts bulging into the lumen although covered; grade 2, stent struts embedded in neointima, but translucently visible; grade 3, stent struts fully embedded and invisible. The extent of uncovered struts was scored as follows: score 0, no uncovered struts of the entire stent; score 1, uncovered struts area approximately <30% of the stent; and score 2, uncovered struts area approximately ≥30% of the stent. In total, 90% of stents demonstrated grade 1 dominant NIC and 10% showed grade 2 dominant NIC; 85% of stents showed an uncovered stent score of 0, and the remainder had a score of 1. Thrombus was observed in all stents.Conclusions:Widely uncovered stent struts were not observed by angioscopy at 3 months after PES implantation in these FP lesions, even with the detection of thrombus adhesion.