Mahmood Zuhdi Ahmad Syadi, Krackhardt Florian, Waliszewski Matthias W, Ismail Muhammad Dzafir, Boxberger Michael, Wan Ahmad Wan Azman
Cardiology Unit, University Malaya Medical Centre, 59100 Kuala Lumpur, Malaysia.
Department of Cardiology and Internal Medicine, Charité-Universitäts Medizin Berlin, Campus Virchow, Berlin, Germany.
Cardiol Res Pract. 2018 Mar 1;2018:8053168. doi: 10.1155/2018/8053168. eCollection 2018.
Coronary revascularization in chronic total occlusion (CTO) is associated with improved clinical outcomes. The choice of the coronary stent is crucial in maintaining long-term vessel patency after CTO revascularization. We investigated the efficacy and safety of polymer-free ultrathin strut sirolimus-probucol coated drug-eluting stents (PF-SES) for CTO lesions.
Patients with CTO lesions treated with PF-SES were identified from the prospective multicenter international ISAR 2000 registry. The primary endpoint was clinically driven target lesion revascularization (TLR) at 9 months. Secondary endpoints were 9-month major adverse cardiac events (death, myocardial infarction, or TLR) (MACE) and the occurrence of stent thrombosis.
A total of 111 patients with CTO lesions (=127) were available for analysis. The 9-month clinical follow-up rate was 91%. The mean reference vessel diameter and lesion length were 2.76 mm ± 0.40 and 26.8 mm ± 13.1, respectively. The overall DAPT duration was 9.7 ± 2.8 months. Only one (1%) in-hospital MI was reported. The TLR and MACE rates at 9 months were 2% (2/101) and 5.9% (6/101), respectively. The 9-month accumulated rates of definite or probable stent thrombosis was 0% (0/101).
Revascularizations for CTO with PF-SES are associated with low rates of TLR and MACE at 9 months with no stent thrombosis. These initial findings need to be compared with results of other new generation DES of larger studies.
慢性完全闭塞病变(CTO)的冠状动脉血运重建与临床预后改善相关。冠状动脉支架的选择对于CTO血运重建术后维持血管长期通畅至关重要。我们研究了无聚合物超薄支柱西罗莫司-普罗布考涂层药物洗脱支架(PF-SES)治疗CTO病变的有效性和安全性。
从前瞻性多中心国际ISAR 2000注册研究中确定接受PF-SES治疗的CTO病变患者。主要终点是9个月时临床驱动的靶病变血运重建(TLR)。次要终点是9个月时的主要不良心脏事件(死亡、心肌梗死或TLR)(MACE)以及支架血栓形成的发生率。
共有111例CTO病变患者(=127处病变)可供分析。9个月的临床随访率为91%。平均参考血管直径和病变长度分别为2.76 mm±0.40和26.8 mm±13.1。总的双联抗血小板治疗(DAPT)持续时间为9.7±2.8个月。仅报告了1例(1%)住院期间心肌梗死。9个月时的TLR和MACE发生率分别为2%(2/101)和5.9%(6/101)。9个月时明确或可能的支架血栓形成累积发生率为0%(0/101)。
PF-SES治疗CTO的血运重建在9个月时TLR和MACE发生率较低,且无支架血栓形成。这些初步发现需要与其他更大规模研究的新一代药物洗脱支架(DES)结果进行比较。