Stent design‐related coronary artery remodeling and patterns of neointima formation following self‐expanding and balloon‐expandable stent implantation

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Abstract
The self-expanding Wallstent (WS) and balloon-expandable Palmaz-Schatz stents (PS) display different mechanical and dynamical stent properties. We analyzed the impact of the respective stent design on coronary wall geometry using quantitative coronary angiography (QCA) and intracoronary ultrasound (ICUS) measurements. Serial measurements were performed within the stent and within reference segments of 50 patients (25 WS, 25 PS). Relative changes for each parameter in both stent designs were calculated (Mann-Whitney U-test; 95% CI). The luminal net gain in WS was not significantly higher in WS compared with PS (1.63 ± 1.11 vs. 1.44 ± 0.63 mm; P = 0.2554). The respective loss indexes were also similar (0.38 ± 0.42 vs. 0.36 ± 0.23; P = 0.8578). The WS segments showed significant postinterventional stent expansion with positive vessel remodeling. The neointima formation was significantly higher in WS segments (4.23 ± 2.07 vs. 2.22 ± 2.22 mm2). The coronary wall morphology and stent geometry after 6.5 ± 1.2 months are related to the stent design. In WS segments, the neointima formation was balanced by postinterventional stent expansion, resulting in a comparable relative lumen loss in both stent types. The respective stent design had no impact on the vessel reference segments. Cathet Cardiovasc Intervent 2002;56:478–486.