Immediate and mid-term outcomes of sirolimus-eluting stent implantation for chronic total occlusions.
OBJECTIVE
To evaluate the outcomes of sirolimus-eluting stent (SES) implantation for the treatment of chronic total occlusion (CTO).


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.


CONCLUSIONS
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.
Ge
Lei
L
EMO Centro Cuore Columbus and San Raffaele Hospital, 48 Via M. Buonarroti, 20145 Milan, Italy.
Iakovou
Ioannis
I
Cosgrave
John
J
Chieffo
Alaide
A
Montorfano
Matteo
M
Michev
Iassen
I
Airoldi
Flavio
F
Carlino
Mauro
M
Melzi
Gloria
G
Sangiorgi
Giuseppe M
GM
Corvaja
Nicola
N
Colombo
Antonio
A
D016022:Case-Control Studies; D002908:Chronic Disease; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000517:prevention & control; D023921:Coronary Stenosis / Q000628:therapy*; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009204:Myocardial Revascularization; D011446:Prospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome
D004343:Drug Implants; D007166:Immunosuppressive Agents; D020123:Sirolimus