title: Treatment of de novo bifurcation lesions: comparison of Sirolimus- and Paclitaxel-eluting stents.
abstract: OBJECTIVE
  Both the sirolimus-(SES) and paclitaxel-eluting (PES) stents have been shown to reduce restenosis rates when used in relatively simple lesions. This study aimed to evaluate the results of a consecutive series of patients treated with drug-eluting stent implantation for de novo bifurcation lesions, and compared outcomes with respect to stenting strategy and stent type.
  
  
  METHODS
  From April 2002 to September 2003, all patients at our institution were treated with drug-eluting stent implantation. A consecutive series of 144 patients were treated for 167 de novo bifurcation lesions with SES, followed by 104 patients treated with PES for 113 lesions.
  
  
  RESULTS
  Clinical follow-up at 6 months was obtained in 99% patients with survival-free of major adverse cardiac events (MACE) of 93.7% for SES versus 85.8% for PES, p=0.05. By multivariate analysis, factors predictive for MACE were age, diabetes mellitus, previous CABG, multivessel disease, treatment for acute myocardial infarction, and treatment with PES. Survival-free of target lesion revascularization (TLR) was 95.7% for SES versus 86.8% for PES, p=0.01, with stent type being the only independent predictor. Technique of stenting was not a predictor of either MACE or TLR.
  
  
  CONCLUSIONS
  MACE rates for both the SES and PES are low compared with historical data of bare metal stents. The most effective techniques for bifurcation stenting remain undefined. Our data suggests a higher need for TLR for the PES compared with the SES, however further randomized studies are needed to fully evaluate both stenting strategy, and any difference between the stents.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Angela
authors.initials: A
authors.lastname: Hoye
authors.forename: Carlos A G
authors.initials: CA
authors.lastname: van Mieghem
authors.forename: Andrew T L
authors.initials: AT
authors.lastname: Ong
authors.forename: Jiro
authors.initials: J
authors.lastname: Aoki
authors.forename: Gaston A
authors.initials: GA
authors.lastname: Rodriguez Granillo
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tsuchida
authors.forename: Georgios
authors.initials: G
authors.lastname: Sianos
authors.forename: Eugene
authors.initials: E
authors.lastname: McFadden
authors.forename: Willem J
authors.initials: WJ
authors.lastname: van der Giessen
authors.forename: Pim J
authors.initials: PJ
authors.lastname: de Feyter
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys