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Ge L, Iakovou I, Cosgrave J, Chieffo A, Montorfano M, Michev I,
Airoldi F, Carlino M, Melzi G, Sangiorgi GM, Corvaja N, Colombo A.
Eur Heart J. 2005 Jun;26(11):1056-62
Comment in: Eur Heart J. 2005 Jun;26(11):1049-51.
Immediate and mid-term outcomes of sirolimus-eluting stent
implantation for chronic total occlusions.
EMO Centro Cuore Columbus and San Raffaele Hospital, 48 Via M.
Buonarroti, 20145 Milan, Italy.
AIMS: To evaluate the outcomes of sirolimus-eluting stent (SES) implantation for
the treatment of chronic total occlusion (CTO). METHODS AND RESULTS: We
identified 122 patients who underwent revascularization in CTO lesions with SES
from April 2002 to April 2004 (SES group). A control group was composed of 259
consecutive patients with CTO lesions treated with bare metal stents (BMS) in
the 24 months immediately before the introduction of SES (BMS group). At 6-month
follow-up, the cumulative rate of major adverse cardiac events (MACE) was 16.4%
in the SES group and 35.1% in the BMS group (P<0.001). The incidence of
restenosis was 9.2% in the SES group and 33.3% in the BMS group (P<0.001). The
need for revascularization in the SES group was significantly lower, both target
lesion revascularization (7.4 vs. 26.3%, P<0.001) and target vessel
revascularization (9.0 vs. 29.0%, P<0.001). BMS implantation (HR: 2.97; 95% CI:
1.80-4.89; P<0.001), lesion length (>20 mm) (HR: 2.02; 95% CI: 1.37-2.99;
P=0.0004), and baseline reference vessel diameter (>2.8 mm) (HR: 0.62; 95% CI:
0.42-0.92; P=0.02) were identified as predictors of MACE during 6-month
follow-up. CONCLUSION: Compared with BMS, SES implantation in CTO lesions
appears to be effective in reducing the incidence of restenosis and the need for
revascularization at 6 months.
PMID: 15817605
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