Background:The detailed mechanism of early-phase arterial healing after novel fluoropolymer-based paclitaxel-eluting stent (PES) implantation in the femoropopliteal (FP) lesions has not been elucidated.

Methods and Results:We evaluated the intravascular status of 20 PES implanted in 11 FP lesions of 9 patients using angioscopy at approximately 3 months after implantation. Angioscopic images were analyzed to determine (1) the dominant degree of neointimal coverage (NIC) over the stent; (2) the extent of uncovered struts; and (3) the presence of intrastent thrombus. NIC was classified into 4 grades: grade 0, stent struts fully visible; grade 1, stent struts bulging into the lumen although covered; grade 2, stent struts embedded in neointima, but translucently visible; grade 3, stent struts fully embedded and invisible. The extent of uncovered struts was scored as follows: score 0, no uncovered struts of the entire stent; score 1, uncovered struts area approximately <30% of the stent; and score 2, uncovered struts area approximately ≥30% of the stent. In total, 90% of stents demonstrated grade 1 dominant NIC and 10% showed grade 2 dominant NIC; 85% of stents showed an uncovered stent score of 0, and the remainder had a score of 1. Thrombus was observed in all stents.

Conclusions:Widely uncovered stent struts were not observed by angioscopy at 3 months after PES implantation in these FP lesions, even with the detection of thrombus adhesion.

背景：新型含氟聚合物紫杉醇洗脱支架（PES）植入股腘（FP）病变后早期动脉愈合的详细机制尚未阐明。

方法和结果：我们在植入后约 3 个月使用血管镜检查评估了植入 9 名患者的 11 个 FP 病变中的 20 个 PES 的血管内状态。分析血管镜图像以确定 (1) 支架上新生内膜覆盖 (NIC) 的主要程度；(2) 未覆盖支柱的范围；(3) 支架内血栓的存在。NIC分为4个等级：0级，支架支柱完全可见；1 级，支架支柱虽然被覆盖但仍伸入管腔；2 级，支架支柱嵌入新内膜，但半透明可见；3 级，支架支柱完全嵌入且不可见。未覆盖支柱的程度评分如下：0分，整个支架无未覆盖支柱；1 分，未覆盖的支柱面积大约 < 支架的 30%；和得分 2，未覆盖的支柱面积大约 ≥ 支架的 30%。总共，90% 的支架显示 1 级显性 NIC，10% 显示 2 级显性 NIC；85% 的支架未覆盖支架评分为 0，其余支架评分为 1。所有支架均观察到血栓。

结论：在 PES 植入后 3 个月，这些 FP 病变中的血管镜检查未观察到广泛暴露的支架支柱，即使检测到血栓粘连。