Optical Frequency Domain Imaging Compares Vascular Response of BMS Versus DES in SFA

January 11, 2017—An investigation of differences in vascular response between self-expanding nitinol bare-metal stents (BMSs) and nitinol paclitaxel-eluting stents (PESs) in superficial femoral artery (SFA) disease using optical frequency domain imaging (OFDI) was recently published by Kojiro Miki, MD, et al in EuroIntervention (2016;12:1551–1558).

As summarized in EuroIntervention, the investigators conducted quantitative vascular angiography (QVA) and OFDI assessments to evaluate vascular response at 6-month postimplantation follow-up. Volume index (VI) was defined as volume divided by stent length. The primary endpoint was OFDI-derived late lumen area loss, defined as lumen VI after stent implantation minus lumen VI at follow-up. Twenty-eight SFA lesions were studied in patients who were randomized to undergo either BMS or PES implantation.

The investigators reported that QVA-derived diameter stenosis at 6-month follow-up was lower in the PES group than in the BMS group (28.5% vs 39.7%; P = .04). After 6 months, BMS VI increased by 33.8% (20.7 ± 3.7 mm³/mm to 27.7 ± 3.5 mm³/mm), and PES exhibited an increase of 32.1% (19.0 ± 2.3 mm³/mm to 25.1 ± 4.7 mm³/mm). Neointimal VI was smaller (7.4 ± 2.6 mm³/mm vs 10.5 ± 3.2 mm³/mm; P < .01), and late lumen area loss was lower (2.9 ± 1.3 mm³/mm vs 5.6 ± 2.8 mm³/mm; P < .01) in the PES group.

Serial volumetric OFDI analyses confirmed significantly smaller amounts of neointimal tissue and lower late lumen area loss after PES implantation for SFA lesions at short-term follow-up, concluded the investigators in EuroIntervention.