מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Results from a study of 100 patients who underwent coronary stent implantation indicate that stent design may have a significant influence on the rate of restenosis.
Dr. Yuji Yoshitomi and colleagues at Tohsei National Hospital, Shizuoka, Japan, note that experimental studies have shown that stent configuration influences intimal hyperplasia. However, "the exact relationship between stent design and clinical outcome is unclear."
The researchers report in the September issue of the American Heart Journal that to investigate, they randomized 100 patients with 107 lesions and symptomatic coronary artery disease to implantation of either of two types of coronary stents. These were the Multilink stent (Advanced Cardiovascular Systems, Guidant) and the GFX stent (Applied Vascular Engineering).
Using quantitative coronary angiography and intravascular ultrasonography, the researchers established that following stent implantation, minimal lumen diameter was significantly larger in the Multilink group and maximal in-stent intimal hyperplasia was significantly greater in the GFX group.
Over an average followup period of 4. 2 months, the restenosis rate was 4% in the Multilink group and 26% in the GFX group (p = 0.003). Furthermore, stent type was the only predictor that significantly correlated with restenosis.
Dr. Yoshitomi told Reuters Health that "the Multilink stent had favorable clinical outcomes compared with the GFX stent. The mechanisms underlying these differences are related to the design of the configuration and the thickness of the wire between the two stents." Stent design, he concluded, "influences the clinical outcomes."
In an accompanying editorial Dr. Jeffrey J. Popma of Brigham and Women's Hospital, Boston, points out that in the United States, the studied devices have been replaced by newer generations of stent designs from both manufacturers. Furthermore, differences in design have lessened over the years and will continue to do so.
However, he observes that in the interim, results from such studies "will continue to contribute to our knowledge of contemporary stent use in clinical practice."
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