Percutaneous coronary interventions with an endothelial progenitor cell capture stent (EPC) for high risk patients with no option for drug eluting stents: long term clinical outcomes of a single centre registry.
OBJECTIVE
Drug eluting stents (DES) are currently considered the gold standard for reducing restenosis of coronary artery lesions. Owing to their effect on the healing process, DES use requires mandatory prolonged dual antiplatelet therapy (DAT). The endothelial progenitor cell (EPC) capture stent, attracting circulating EPCs, promotes vascular healing and allows a short post-procedural period of DAT. The aim of the present study was to evaluate the short and long term clinical outcomes of the use of the Genos R stent™ in a selected high risk population with "no option" for DES.


RESULTS
From December 2005 to October 2008, 61 high risk patients with clear contraindications to a prolonged period of DAT who underwent PCI with EPC capture stent implantation in our institution were prospectively selected and analysed. Technical success rate was 100%. Procedural success rate was 95.1%. After two years, major adverse cardiovascular events (MACE) free survival was 80.6%. According to the Academic Research Consortium definitions, cardiac death occurred in 1.6% of patients, and re-infarction, target lesion revascularisation (TLR), and target vessel revascularisation (TVR) occurred in 6.6%, 9.8%, and 11.5% of patients, respectively. Definite stent thrombosis occurred in one patient (specifically at 0 days). In patients who underwent surgery, no post-procedural MACE and no stent thrombosis were recorded.


CONCLUSIONS
EPC capture stent implantation in high-risk patients with no option for DES seems encouraging, with satisfactory clinical outcomes both at short and at long term follow-up.
Interventional Cardiology Department, San Giovanni Battista Hospital, Turin, Italy.
Paolo
P
Scacciatella
Emanuele
E
Meliga
Maurizio
M
D'Amico
Gianluca
G
Amato
Mauro
M
Pennone
Federico
F
Conrotto
Sebastiano
S
Marra
D000368:Aged; D057005:Bioengineering; D020099:Coated Materials, Biocompatible; D023903:Coronary Restenosis / Q000517:prevention & control*; D023921:Coronary Stenosis / Q000628:therapy; D003331:Coronary Vessels; D042783:Endothelial Cells / Q000166:cytology*; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D013234:Stem Cells / Q000166:cytology*; D015607:Stents / Q000009:adverse effects
D020099:Coated Materials, Biocompatible