title: Small vessel stenting with cobalt-chromium stents (Arthos Pico) in a real world setting.
abstract: BACKGROUND
  In current clinical practice, 35-67% of significant coronary artery lesions are located in small (<3.0 mm) vessels, a setting with poor short- and long-term results after percutaneous coronary interventions.
  
  
  OBJECTIVE
  The aim of the present Arthos Pico Austria Multicenter Registry is to demonstrate the safety and efficacy of the Arthos Pico (cobalt-chromium alloy) stent implantation in small coronary arteries in a real world setting.
  
  
  METHODS
  Two hundred and three patients (mean age, 67+/-12 years; 63% male) were included in the Registry; 199 patients (98%) were controlled clinically (including noninvasive stress tests) 6 and 12 months after stent implantation. Clinically driven angiographic controls were performed in 37 patients (18.2%) at mean 6 months after stenting. The primary endpoint of the study was the 6-month rate of major adverse cardiac events (as target vessel revascularization, all cause death, and acute myocardial infarction), the secondary endpoints were the intervention complications, and the occurrence of acute and subacute stent thrombosis.
  
  
  RESULTS
  The procedural success was 99%. The rates of acute and subacute stent thrombosis were 0.5 and 1.5%, respectively. During the 6-month clinical follow-up, primary endpoint events (major adverse cardiac events) were recorded in 13% of the clinically controlled patients: four patients (2%) with acute myocardial infarction; 12 patients (6%) with target vessel revascularization; and 10 patients died (5%), resulting in an event-free survival rate of 87%. Between the 6- and 12-month follow-up, additional target vessel revascularization was performed in three patients, acute myocardial infarction and death occurred in one patient each, respectively. Thus, the 12-month major adverse cardiac event-free survival rate was 85%. Patients who died had older age (76+/-7 years) and a high proportion of type C lesions (50%) at the initial angiography. Multivariate analysis revealed older age (P=0.026) and type C lesions (P=0.016) as significant predictors for all causes of death.
  
  
  CONCLUSIONS
  In conclusion, stenting of small arteries with Arthos Pico is safe and effective in the prevention of major adverse cardiac events during 6- and 12-month follow-up.
authors.affiliation: Department of Cardiology, Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Strehblow
authors.forename: Mariann
authors.initials: M
authors.lastname: Gyöngyösi
authors.forename: Gerald
authors.initials: G
authors.lastname: Zenker
authors.forename: Hubert
authors.initials: H
authors.lastname: Wallner
authors.forename: Matthias
authors.initials: M
authors.lastname: Heigert
authors.forename: Peter
authors.initials: P
authors.lastname: Siostrzonek
authors.forename: Robert
authors.initials: R
authors.lastname: Tischler
authors.forename: Peter
authors.initials: P
authors.lastname: Probst
authors.forename: Irene
authors.initials: I
authors.lastname: Lang
authors.forename: Heinz
authors.initials: H
authors.lastname: Sochor
authors.forename: Dietmar
authors.initials: D
authors.lastname: Glogar
mesh_terms: D000368:Aged; D001160:Arterioles / Q000601:surgery*; D002858:Chromium Alloys / Q000009:adverse effects; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D002858:Chromium Alloys