Sirolimus-eluting stents for the treatment of atherosclerotic ostial lesions.
BACKGROUND
Ostial atherosclerotic lesions are distinct from other lesion sites in terms of outcomes following percutaneous interventions. Despite aggressive lesion modification strategies, long-term outcome is hampered by restenosis. Various stent designs have failed to show significant improvement in target lesion revascularization (TLR) rates. The present study evaluates the clinical outcomes following sirolimus-eluting stent implantation for ostial lesions.


METHODS
The sirolimus-eluting stent (SES) was the device of choice at our institute for all coronary interventions from April 2002 to March 2003. This study population is comprised of 50 patients who received drug-eluting stents for atherosclerotic ostial lesions during this period. Sixty-eight percent of the patients were male and 24 patients (48%) had a history of previous revascularization. Indication for intervention were as follows: acute myocardial infarction, 7 patients (14%), stable angina, 23 patients (46%), unstable angina, 20 patients (40%). Angioplasty and stent implantations were done according to the standard protocol. All patients were prospectively followed up for major adverse cardiac events. The event-free survival was 90% at one year. There were 5 (10%) target vessel revascularization, 3 (6%) myocardial infarctions and 1 (2%) death during a mean follow-up of 414.5 +/- 54.5 days. TLR was required in 4 (8%) patients.


CONCLUSIONS
SES implantation is feasible in ostial locations and is associated with low subsequent revascularization.
Vijayakumar
Maniyal
M
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Rodriguez Granillo
Gastón A Alfredo
GA
Lemos
Pedro A
PA
Aoki
Jiro
J
Hoye
Angela
A
Ong
Andrew T L
AT
McFadden
Eugene P
EP
Sianos
Georgios
G
Hofma
Sjoerd H
SH
Smits
Pieter C
PC
van der Giessen
Willem J
WJ
de Feyter
Pim
P
van Domburg
Ron T
RT
Serruys
Patrick W
PW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019917:Blood Vessel Prosthesis Implantation; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D020123:Sirolimus / Q000627:therapeutic use*; D015607:Stents; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D007166:Immunosuppressive Agents; D020123:Sirolimus