Impact of sirolimus-eluting stent on the outcome of patients with chronic total occlusions.
Several randomized trials have demonstrated that stent implantation after successful recanalization of long-term total occlusions decreases restenosis and reocclusion rates. The sirolimus-eluting stent (SES) has recently proved its efficacy to decrease restenosis in selected patients. However, the efficacy of SES implantation in patients who have chronic total occlusions is currently unknown. Therefore, we investigated procedural and 6- and 12-month angiographic outcomes (analyzed by quantitative coronary angiography) and left ventricular function in 60 patients who received SESs and 120 patients who received bare metal stents (BMSs). Minimum luminal diameter did not differ immediately after recanalization (SES group 3.04 +/- 0.50 mm vs BMS group 3.12 +/- 0.48 mm). After 6 months, the SES group still had significantly larger luminal diameters (3.04 +/- 0.44 mm vs 1.94 +/- 0.98 mm) and significantly lower restenosis and reocclusion rates (2% and 0%, respectively) than did the BMS group (32% and 6%, respectively). Late loss was significantly smaller in the SES group than in the BMS group. At follow-up, the SES group had fewer cardiac events, including target lesion revascularization (p <0.001), than did the BMS group. In conclusion, SES implantation after recanalization of chronic total occlusion provides a better clinical outcome with less restenosis and target lesion revascularization after 6 months than does BMSs.
Nakamura
Sunao
S
Department of Cardiology, New Tokyo Hospital, 473-1 Nemoto, Matsudo-shi, Chiba 271-0077, Japan. boss@ryukyu.ne.jp
Muthusamy
Tamil Selvan
TS
Bae
Jang-Ho
JH
Cahyadi
Yeo Hans
YH
Udayachalerm
Wasan
W
Tresukosol
Damras
D
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007564:Japan; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D020123:Sirolimus