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약물용출 스텐트에서 Late Catchup이 존재하는가? 정량적 혈관조영술 결과
서울대학교병원 순환기내과/심혈관센터
박경우, 김치훈, 정진욱, 이해영, 강현재, 구본권, 김효수, 오병희, 박영배
Background and Objectives: Recent studies have suggested the possibility of late catch up after drug eluting stent implantation especially in 'limus' drug eluting stents compared with paclitaxel-eluting stents . There is limited data on whether latch catch up exists in currently used stents such as Cypher SelectTM and Taxus Express(Liberte)TM. With QCA parameters of serial assessment, we compare luminal loss between early phase and late phase in patients receiving Taxus and Cypher stents. Subjects and Methods: We collected data from serial angiographic followup of patients enrolled in other trials that mandated both a 6-month early angiographic followup and a 18-month or longer late angiographic followup. QCA analysis was performed at baseline, early, and late followup to compare minimal lumen diameter, luminal loss, and diameter stenosis. Results: For the Taxus stent, serial angiographic follow-up was available in 64 patients, 94 target lesions. Mean time interval from stent implantation was 6.4 and 22.9 months respectably. There was a small but significant additive late luminal loss from early to late angiographic followup (0.102±0.228mm, p < 0.01). However, this was not associated with a significant change in diameter stenosis and further revascularization procedures occcured in 4 of the total 94 lesions (4.3%). We are performing similar evaluation in patients that received Cypher stents. We will present these data at the meeting. Conclusion: Most of the reduction in minimum lumen diameter after Taxus stent implantation occurred during the first six months. Although there was a small but significant late catch up from 6 months to late followup (mean 23months), this did not result in a significant increase in diameter stenosis and only caused repeat procedures in approximately 4% of the lesions.


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