Use of multiple overlapping sirolimus-eluting stents for treatment of long coronary artery lesions : results from a single-center registry in 318 consecutive patients
Articolo
Data di Pubblicazione:
2009
Citazione:
Use of multiple overlapping sirolimus-eluting stents for treatment of long coronary artery lesions : results from a single-center registry in 318 consecutive patients / P.E. Ruchin, D. Trabattoni, F. Fabbiocchi, P. Montorsi, A. Lualdi, P. Ravagnani,
L. Grancini, S. Galli, G. Teruzzi, G. Calligaris, S. De Martini, A.L. Bartorelli. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - 134:2(2009 May 15), pp. 231-237.
Abstract:
Drug-eluting stents (DES) are superior to bare metal stents in the prevention of restenosis and target lesion revascularization (TLR). This has led to a more aggressive use of DES in everyday interventional cardiology practice.
Methods: All consecutive patients who underwent coronary artery stenting with greater than 34 mm of overlapping, sirolimus-eluting stent (SES) were reviewed from a prospectively created database. A prespecified group of patients with greater than 60 mm of SES was also followed.
Results: 318 patients were followed up at a minimum of 6 months and a mean of 9 months. The mean target lesion stented length was over 55 mm. Use of IVUS was 19.8%. Forty patients (12.6%) suffered a peri-procedural CK-MB rise. The MACE rate at 9 months was 17% with 12.6% being periprocedural myocardial infarction (MI). Clinically driven TLR was 4.4% and cardiac death was 1.3%. There were 4 cases defined as late stent thrombosis. The independent predictors of periprocedural MI were the presence of a major side branch and longer target lesion stented length, with stable angina being a negative predictor. The independent predictors of in-stent restenosis were unstable angina and target lesion number per patient. There was a trend to increased MACE in the subgroup with longer than 60 mm of SES length.
Conclusion: The use of multiple, overlapping SES is safe and effective with an acceptably low follow up MACE rate. A significant periprocedural CK-MB rise appears to be a risk of long segment stenting. Whether this translates to long-term sequelae needs further investigation.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Drug eluting stents ; Coronary artery ; Overlapping ; Sirolimus
Elenco autori:
P.E. Ruchin, D. Trabattoni, F. Fabbiocchi, P. Montorsi, A. Lualdi, P. Ravagnani,
L. Grancini, S. Galli, G. Teruzzi, G. Calligaris, S. De Martini, A.L. Bartorelli
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