Sirolimus-eluting stents in the treatment of chronic total coronary occlusions: results from the prospective multi-center German Cypher Stent Registry.
OBJECTIVE
We assessed the effectiveness and safety of the sirolimus-eluting stent (SES) in the treatment of chronic total coronary occlusions.


BACKGROUND
Chronic total occlusions (CTO) of coronary vessels have an unacceptable high restenosis rate of approximately 50% after stenting. Few data exist about the performance of drug eluting stents (DES) in the treatment of CTO.


METHODS
All coronary interventions using the Cypher stent performed at 122 centers engaged in the German Cypher registry between April 2002 and December 2004 were analyzed; a total of 5,344 patients; 374 with and 4,970 without CTO were compared.


RESULTS
There was no significant difference between both groups regarding demographics, coronary status and left ventricular function. Patients in the CTO group had a higher level of angina symptoms, the coronary lesions were more complex and the stents used were smaller and longer than in the No-CTO group. The In-hospital outcome was similar in both groups, with importantly no difference regarding mortality and complications. Stenting was as successful in the CTO as in the No-CTO group; during a follow-up of 6.6 months we found no significant difference regarding the rate of mortality, complications, and revascularization between both groups.


CONCLUSIONS
Implantation of the Cypher stent reduces the restenosis rate and seems to be a safe and effective tool for the treatment of chronic total coronary occlusions.
Klinikum Lippe-Detmold, Detmold, Germany. christian.zellerhoff@klinikum-lippe.de
Christian
C
Zellerhoff
Steffen
S
Schneider
Jochen
J
Senges
Thomas
T
Pfannebecker
Christian
C
Hamm
Ulrich
U
Tebbe
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000401:mortality; D001807:Blood Vessel Prosthesis; D002908:Chronic Disease; D054059:Coronary Occlusion / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology; D016503:Drug Delivery Systems; D054855:Drug-Eluting Stents; D005260:Female; D005858:Germany; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D020123:Sirolimus