OBJECTIVES Aim of this study was to evaluate different response in platelet reactivity and vessel healing using high-resolution frequency-domain optical coherence tomography (FD-OCT) in patients with femoropopliteal artery disease treated with ZILVER PTX drug eluting stents (DES), and randomly assigned to clopidogrel or ticagrelor for 12 months. BACKGROUND The optimal antithrombotic regimen for long-term management of patients with peripheral artery disease (PAD) after revascularization is poorly defined and often extrapolated from trials performed on patients undergoing percutaneous coronary intervention. METHODS In this single center randomized trial 40 patients with femoropopliteal artery disease treated with ZILVER PTX DES stents, were randomized to Ticagrelor (T) + Aspirin for 3 months, subsequently continuing Ticagrelor alone for another 9 months or Clopidogrel (C) + Aspirin for 3 months, subsequently continuing Clopidogrel alone for 9 months. Platelet reactivity via the P2Y12 pathway was evaluated at baseline and at 3 months follow-up, angiographic and FD-OCT follow-up along the entire stented segment was performed at 12 months. RESULTS No significant difference between T and C group was found concerning net percentage volume obstruction (29.7% ± 17.6% vs. 31.2% ± 10.7%; p = 0.78). FD-OCT at 12 months showed a high percentage of uncovered stent struts in both groups: 24.2% ± 32.8% in the T group vs 15.3% ± 15.8% in the C group (p = 0.4). Mean values of platelet reactivity units (PRU) at 3 month follow-up were 81 ± 72 in the T group and 200 ± 61 in the C group (p < 0.001). CONCLUSIONS Significantly higher platelet reactivity remains in patients treated with clopidogrel as compared to ticagrelor 3 months after PTA and stent implantation. Ticagrelor does not reduce neointimal proliferation in patients treated with DES in the femoropopliteal district as compared with clopidogrel. A large amount of uncovered stent struts at 12-month follow-up was found in these patients regardless of the antiplatelet treatment assumed.

中文翻译：

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替卡格雷洛与氯吡格雷在股pop区植入紫杉醇洗脱支架的患者：使用频域光学相干断层扫描的随机先导研究。

目的本研究旨在通过高分辨率频域光学相干断层扫描（FD-OCT）评估经ZILVER PTX药物洗脱支架（DES）治疗的股pop动脉疾病患者的血小板反应性和血管愈合的不同反应分配给氯吡格雷或替卡格雷治疗12个月。背景技术血运重建后用于长期治疗外周动脉疾病（PAD）的患者的最佳抗血栓治疗方案定义不清，通常是从对经皮冠状动脉介入治疗的患者进行的试验中推断得出的。方法在该单中心随机试验中，将40例采用ZILVER PTX DES支架治疗的股pop动脉疾病患者随机分为Ticagrelor（T）+阿司匹林3个月，随后单独继续使用替卡格雷洛9个月，或继续使用氯吡格雷（C）+阿司匹林3个月，随后继续继续使用氯吡格雷9个月。在基线和3个月随访时评估通过P2Y12途径的血小板反应性，在12个月对整个支架段进行血管造影和FD-OCT随访。结果T组和C组在净体积阻塞方面无显着差异（29.7％±17.6％对31.2％±10.7％； p = 0.78）。两组在12个月时的FD-OCT均显示出较高的未覆盖支架撑杆：T组为24.2％±32.8％，而C组为15.3％±15.8％（p = 0.4）。T组3个月随访时血小板反应单位（PRU）的平均值为81±72，C组为200±61（p <0.001）。结论与PTA和支架植入后3个月的替加格雷相比，氯吡格雷治疗的患者的血小板反应性仍然显着更高。与氯吡格雷相比，替卡格雷洛在股lite区经DES治疗的患者中未减少新内膜增生。无论采用哪种抗血小板治疗方法，这些患者在12个月的随访中均发现了大量未发现的支架撑杆。