BACKGROUND: Intravascular sonotherapy (IST) reduces neointimal hyperplasia post-stenting in animal studies. Euro-SPAH is a multi-center, double blind, randomized trial investigating the efficacy of IST to reduce in-stent late loss. METHODS: Patients with angina or silent ischaemia with stented de novo lesions were randomised to sham or IST. The sample size had a 90% power to detect a late loss difference of 0.21 mm at 6 months. The secondary endpoints were MACE at 1, 6, 12 months and neo-intimal hyperplasia on IVUS at 6 months. RESULTS: At 23 sites in Europe, 403 patients were randomized, with successful treatment with sham or IST in 95.6%. There were no significant differences between the groups in terms of baseline demographics or lesion characteristics. Angiographic follow-up was obtained in 89%. In-stent late loss was not significantly different. The restenosis rate at 6 months was 23% in the IST group versus 25% in the sham group. The IVUS measurements confirm the absence of effect of IST on neointimal hyperplasia. At one year, the event-free survival did not significantly differ between the two groups. CONCLUSION: The use of sonotherapy following stent implantation in de novo lesions does not reduce intra-stent neointimal hyperplasia, or effect the angiographic restenosis rate compared to sham treatment.

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Keywords *Stents, *Ultrasonography, Interventional, Aged, Blood Vessel Prosthesis Implantation, Coronary Angiography, Coronary Disease/mortality/radiography/*surgery, Coronary Restenosis/mortality/radiography/*therapy, Disease Progression, Double-Blind Method, Europe/epidemiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Reoperation, Survival Analysis, Time Factors, Treatment Outcome
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Serruys, P.W.J.C., Hoye, A., Grollier, G., Colombo, A., Symons, J., & Mudra, H.. (2004). A European multi-center trial investigating the anti-restenotic effect of intravascular sonotherapy after stenting of de novo lesions (EUROSPAH: EUROpean Sonotherapy Prevention of Arterial Hyperplasia).. International Journal of Cardiovascular Interventions, 6(2), 53–60. doi:10.1080/14628840410030405