Comparison between sirolimus- and Paclitaxel-eluting stents for the treatment of chronic total occlusions.

OBJECTIVES

This study evaluated the clinical and angiographic effectiveness of sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) implantation for chronic total occlusion (CTO) lesions.

BACKGROUND

It has not been known which drug-eluting stent, SES vs. PES, is superior for the treatment of CTO lesions.

METHODS

This study comprises 107 CTO lesions which were successfully treated with SES implantation and 29 CTO lesions with PES implantation. Six-month angiographic restenosis rates and major adverse cardiac events (MACE) including death, nonfatal myocardial infarction and target lesion revascularization were compared between the two groups.

RESULTS

Baseline clinical characteristics were similar between the two groups. The procedural success rate was 98.1% in the SES group and 100% in the PES group. There was 1 sudden death due to in-hospital acute thrombosis in the PES group. There were no significant differences in baseline angiographic measures between both groups, except larger postprocedural minimal luminal diameter and acute gain in the PES group. At 6-month angiographic follow up, the restenosis rate was significantly higher in the PES group (28.6% vs. 9.4%; p = 0.020). Similarly, the late loss was significantly higher in the PES group (0.8 +/- 0.8 mm vs. 0.4 +/- 0.8 mm; p = 0.025). At one-year follow up, the MACE-free survival rate was significantly higher in the SES group (95.8% vs. 85.8%; p = 0.049).

CONCLUSIONS

The implantation of SES in the treatment of CTO lesions showed more favorable results regarding restenosis and clinical outcomes compared with PES implantation.