Clinical and angiographic outcome after sirolimus-eluting stent implantation in aorto-ostial lesions.
OBJECTIVE
This observational study evaluated the clinical and angiographic outcomes of patients with aorto-ostial coronary artery disease treated with sirolimus-eluting stents (SESs) or with bare metal stents (BMSs).


BACKGROUND
The safety and effectiveness of SESs for the treatment of aorto-ostial lesions have not been demonstrated.


METHODS
We identified 82 consecutive patients who underwent percutaneous coronary interventions in 82 aorto-ostial lesions using the SES (32 patients) or BMS (50 patients) and compared the two groups of patients. The incidence of major adverse cardiac events (MACE), including death or Q-wave myocardial infarction (MI), target lesion revascularization (TLR), and target vessel revascularization (TVR), were recorded in-hospital and at a 10-month follow-up.


RESULTS
All stents were implanted successfully. There were no statistically significant differences regarding major in-hospital complications between the two groups. At 10-month follow-up, two (6.3%) patients in the SES group and 14 (28%) patients in the BMS group underwent TLR (p = 0.01); MACE were less frequent in the SES group compared to the BMS group (19% vs. 44%, p = 0.02). Angiographic follow-up showed lower binary restenosis rates (11% vs. 51%, p = 0.001) and smaller late loss (0.21 +/- 0.31 mm vs. 2.06 +/- 1.37 mm, p < 0.0001) in the SES group.


CONCLUSIONS
The main finding of our study is that, compared to the BMS, implantation of the SES in aorto-ostial lesions appears safe and effective, with no increase in major in-hospital complications and a significant improvement in restenosis and late event rates at 10-month follow-up.
Iakovou
Ioannis
I
Centro Cuore Columbus, Milan, Italy.
Ge
Lei
L
Michev
Iassen
I
Sangiorgi
Giuseppe M
GM
Montorfano
Matteo
M
Airoldi
Flavio
F
Chieffo
Alaide
A
Stankovic
Goran
G
Vitrella
Giancarlo
G
Carlino
Mauro
M
Corvaja
Nicola
N
Briguori
Carlo
C
Colombo
Antonio
A
D000368:Aged; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000517:prevention & control*; D023921:Coronary Stenosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents
D007166:Immunosuppressive Agents; D020123:Sirolimus