title: Two-year outcome of the use of paclitaxel-eluting stents in aorto-ostial lesions.
abstract: BACKGROUND
  Percutaneous treatment of stenoses involving aorto-ostial lesions is technically demanding and has been associated with lower procedural success and poorer clinical and angiographic outcomes when compared with non-ostial lesions. This study evaluated the immediate and long-term (2-year) outcome of aorto-ostial stenoses treated with paclitaxel-eluting stents (PES).
  
  
  METHODS
  From February 2003 to December 2004, a total of 76 consecutive patients with 76 lesions underwent percutaneous intervention with PES for aorto-ostial lesions (right coronary artery, 37; left main, 26; saphenous vein graft, 13). All patients were clinically followed for the occurrence of major adverse cardiac events (MACE), defined as cardiac death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR) or target vessel revascularization (TVR).
  
  
  RESULTS
  All stents (1.7/lesion) were successfully deployed. Three lesions (3.9%) were pre-treated with debulking devices. Thirty-seven lesions (48.7%) were post-dilated with non-compliant balloons (balloon/artery ratio, 1.2). Stents were positioned protruding into the aortic lumen in 29 lesions (38.2%). Cumulative 2-year event-free survival was 68.4%. There was one angiographically-proven stent thrombosis occurring 427 days after TLR for restenosis after the index procedure. The restenosis rate at 7 months (median) was 20.0% and in-stent late lumen loss was 0.48 mm in 40 patients with angiographic follow-up.
  
  
  CONCLUSIONS
  Utilization of PES in this complex lesion subset is feasible and associated with favorable angiographic results at 7 months. However, the gradual increase in later events up to 2 years suggests that aorto-ostial disease remains problematic even in the era of drug-eluting stents.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tsuchida
authors.forename: Joost
authors.initials: J
authors.lastname: Daemen
authors.forename: Shuzou
authors.initials: S
authors.lastname: Tanimoto
authors.forename: Héctor M
authors.initials: HM
authors.lastname: García-García
authors.forename: Neville
authors.initials: N
authors.lastname: Kukreja
authors.forename: Sophia
authors.initials: S
authors.lastname: Vaina
authors.forename: Andrew T L
authors.initials: AT
authors.lastname: Ong
authors.forename: Georgios
authors.initials: G
authors.lastname: Sianos
authors.forename: Peter P T
authors.initials: PP
authors.lastname: de Jaegere
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000639:trends; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality; D054855:Drug-Eluting Stents / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D011859:Radiography; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D017239:Paclitaxel