title: Clinical and angiographic follow-up after overlapping implantation of polytetrafluoroethylene covered stents with drug eluting stents.
abstract: Polytetrafluoroethylene-covered stents (PCS) were recently proposed as a new modality mainly for the treatment of saphenous vein graft lesions, but restenosis occurring principally at the edges restricted their clinical use in the management of coronary aneurysms and perforations.
  
  
  OBJECTIVE
  To investigate the safety and effectiveness of the overlapping implantation of drug-eluting stents (DES) with PCS in clinical scenarios where the latter are indicated.
  
  
  METHODS
  Since April 2002, when DES were introduced in clinical practice, 14 consecutive patients were -treated with overlapping implantation of PCS with DES in 3 centres. Seven patients were treated for coronary aneurysms, 5 for coronary perforations and 2 for branch occlusion. The incidence of any major adverse cardiac events defined as death, myocardial infarction (MI), and target vessel revascularisation (TVR) was retrospectively evaluated. A control angiography was available in 13 patients, and quantitative coronary angiography was performed before and after the intervention and at follow-up to evaluate restenosis rate and late loss.
  
  
  RESULTS
  At a mean clinical follow-up of 21.9 months there were no deaths or MI's, while one patient with occlusive restenosis underwent successful TVR (7.7%). At angiographic follow-up (mean: 9.7 months) there was one patient with restenosis (7.7%), who had a total occlusion. After excluding the patient with the occlusive restenosis mean diameter stenosis was 22.4+/-11.7% and late loss was 0.18+/-0.35 mm at follow-up. No early or late stent thrombosis occurred.
  
  
  CONCLUSIONS
  Overlapping implantation of PCS with DES seems to be a safe and effective therapeutic modality demonstrating a low incidence of clinical and angiographic restenosis.
authors.affiliation: Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Michail I
authors.initials: MI
authors.lastname: Papafaklis
authors.forename: Georgios
authors.initials: G
authors.lastname: Sianos
authors.forename: Ben
authors.initials: B
authors.lastname: Cost
authors.forename: Sophia
authors.initials: S
authors.lastname: Vaina
authors.forename: Athanassios
authors.initials: A
authors.lastname: Manginas
authors.forename: Petros S
authors.initials: PS
authors.lastname: Dardas
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsikaderis
authors.forename: Carlos A
authors.initials: CA
authors.lastname: van Mieghem
authors.forename: Lampros K
authors.initials: LK
authors.lastname: Michalis
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys