Treatment of multilesion coronary artery disease with simultaneous drug-eluting and bare-metal stent implantation: clinical follow up and angiographic mid-term results.
OBJECTIVE
We sought to evaluate clinical and angiographic outcomes of percutaneous coronary intervention (PCI) in patients receiving both bare-metal stents (BMS) and drug-eluting stents (DES).


BACKGROUND
Few data are available about the safety and efficacy of the practice namely called "hybrid PCI".


METHODS
One hundred and eighty-six patients, 502 de novo lesions, received during PCI both BMS (n = 266) and DES (316), with a mean of 3.1 +/- 1.2 stents/patient. Cumulative major adverse cardiac events were analyzed at 24 +/- 22 months.


RESULTS
Clinical follow up was carried out in 100% of eligible patients. Angiographic follow up at 8.6 +/- 4.4 months was achieved in 70.4% of patients, 71.6% of stents and 72.5% of lesions. Binary restenosis was 12.9% vs. 20.6% (p = 0.034) in DES vs. BMS, respectively; late loss was significantly higher in BMS than in DES (0.67 +/- 0.73 vs. 0.35 +/- 0.71 mm; p < 0.001). DES showed less lumen loss and binary restenosis rates than BMS in B2/C lesions (p < 0.001 and 0.007, respectively), while any significant difference was detected in A/B1 lesions (p = 0.27 and 0.76, respectively).


CONCLUSIONS
The simultaneous use of DES and BMS is safe and provides similar results for the 2 stents only in simple lesions. In complex lesions, BMS offer restenosis and a target lesion revascularization rates significantly higher than with DES.
Mirabella
Francesca
F
Department of Cardiology, Ferrarotto Hospital, University of Catania, Italy.
Francaviglia
Bruno
B
Capodanno
Davide
D
Di Salvo
Maria Elena
ME
Galassi
Alfredo Ruggero
AR
Ussia
Gian Paolo
GP
Capranzano
Piera
P
Tamburino
Corrado
C