Senguttuvan Nagendra Boopathy, Kongara Rahul, Sadhanandham Shanmugasundram, Srinivasan Nishok Victory, Periyasamy Santhosh Kumar, Vinod Kumar Balakrishnan, Shankar P Ravi, Iyer Meena, Ramadoss Mahalakshmi, Subramanian Vinodhini, Venkata Balasubramaniyan Jayanthy, Krishnamurthy Preetam, Ramesh Sankaran, Manokar Panchanatham, Muralidharan Thoddi Ramamurthy, Murthy Jayanthi Sathyanarayana, Thanikachalam Sadagopan
Department of Cardiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Porur, Chennai, Tamil Nadu 600116, India.
Adjunct Faculty, Department of Engineering and Design, Indian Institute of Technology-Madras, Chennai, India.
Cardiol Res. 2022 Apr;13(2):104-109. doi: 10.14740/cr1357. Epub 2022 Apr 5.
Diffuse long coronary lesions are difficult to treat percutaneously. The aim of the present study was to assess the procedural safety and long-term efficacy of the ultra-long (48-mm) drug-eluting stent Xience Xpedition.
This was an investigator-initiated, observational, all-comers study. A total of 92 patients with 93 lesions were enrolled in the study from October 2016 to October 2020. The primary outcome of the study was major adverse cardiac events (MACEs). Secondary outcomes were individual components of the primary outcome and procedural success.
The mean (standard deviation (SD)) age of the participants was 58.8 (10.8) years. More than half of the patients had ST-segment elevation myocardial infarction (STEMI) at presentation (55.4%). Ten patients were in cardiogenic shock (CGS; 10.8%). Most of the lesions were located in the left anterior descending artery (48.3%). American College of Cardiology/American Heart Association (ACC/AHA) type C was the most common lesion type amongst the intervened vessels (46.74%), with a mean syntax score (SD) of 16.99 (8.89). The mean stent diameter used was 2.77 mm (0.25). MACE was observed in 7.6% of patients studied at a median follow-up of 24 months. MACE was significantly lower in the population without CGS, occurring in only 2.4% of the patients; a significant difference in MACE was observed in patients with and without CGS (P < 0.001). Procedural success was obtained in 89.2% of total population; however, 96.3% of patients without CGS had procedural success.
The deployment of the ultra-long 48-mm Xience Xpedition stent is feasible, safe, and effective; and it was associated with a good intermediate-term clinical outcome.
弥漫性长冠状动脉病变经皮治疗困难。本研究旨在评估超长（48毫米）药物洗脱支架Xience Xpedition的手术安全性和长期疗效。
这是一项由研究者发起的观察性、纳入所有患者的研究。2016年10月至2020年10月期间，共有92例患者的93处病变纳入本研究。本研究的主要结局是主要不良心脏事件（MACE）。次要结局是主要结局的各个组成部分以及手术成功率。
参与者的平均（标准差）年龄为58.8（10.8）岁。超过一半的患者就诊时患有ST段抬高型心肌梗死（STEMI）（55.4%）。10例患者出现心源性休克（CGS；10.8%）。大多数病变位于左前降支（48.3%）。美国心脏病学会/美国心脏协会（ACC/AHA）C型是介入血管中最常见的病变类型（46.74%），平均SYNTAX评分（标准差）为16.99（8.89）。使用的平均支架直径为2.77毫米（0.25）。在中位随访24个月时，7.6%的研究患者观察到MACE。无CGS的人群中MACE显著更低，仅2.4%的患者发生；有和无CGS的患者在MACE方面观察到显著差异（P<0.001）。89.2%的总人群获得手术成功；然而，无CGS的患者中有96.3%手术成功。
超长48毫米Xience Xpedition支架的植入是可行、安全且有效的；并且与良好的中期临床结局相关。
