title: Multi-Link Vision stent vs. first-generation drug-eluting stents: systematic review and meta-analysis.
abstract: BACKGROUND
  Since its introduction, the cobalt chromium alloy MULTI-LINK VISION stent (MLV) has been extensively investigated thus leading to the largest amount of data so far available for a bare metal stent. Aim and
  
  
  METHODS
  Systematic review and meta-analysis (according to Cochrane collaboration guidelines) aiming at summarizing the real world safety and efficacy of MLV stent. Endpoints of interest were: major adverse events [(MAE) combination of overall death and non-fatal myocardial infarction, MI], and target vessel revascularization (TVR). Rate of stent thrombosis was also assessed.
  
  
  RESULTS
  Eleven studies finally retrieved totalling 5539 patients [7 study registries, 4243 patients and 4 randomized controlled trials (RCTs) comparing MLV vs. first generation of drug-eluting stent (DES) (paclitaxel or sirolimus eluting), (RCTs) 1296 patients]. Across study registries, at a mean follow-up of 11.1 months, MLV was associated with a 5.3% risk of MAE, 3% of death, 2.3% of MI and a 9% of TVR. Risk of ST was 0.5%. Compared to first generation of DES in RCTs, at a mean follow-up of 10.5 months, MLV achieved similar results in terms of MAE, death and MI. On the other hand, MLV was associated with a double risk of TVR [OR 2.01 (1.34-3.01), P < 0.001, number needed to treat 18 (13-40)]. Overall, in stent late loss with MLV was 0.81 mm (±0.51), while the in segment late loss was 0.61 mm (±0.5). Risk of stent thrombosis was equivalent. Of note, performance of MLV in terms of safety, efficacy and risk of repeat revascularization was quite consistent across all the published studies, despite inherent differences in study design, clinical setting, complexity of the lesions and ethnicity.
  
  
  CONCLUSIONS
  Compared to first-generation DES, MLV showed substantial equivalence with respect to hard clinical endpoints. Data are consistent in study registries and RCTs meaning that the overall performance of MLV is quite predictable and reproducible into the wide spectrum of clinical settings.
authors: Interventional Cardiologist, Department of Interventional Cardiology, S. Ambrogio Clinical Institute, Milan, Italy. luctes@gmail.com
authors: L
authors: L
authors: Testa
authors: R A
authors: RA
authors: Latini
authors: S
authors: S
authors: Pizzocri
authors: S
authors: S
authors: Lanotte
authors: M
authors: M
authors: Agnifili
authors: M L
authors: ML
authors: Laudisa
authors: N
authors: N
authors: Brambilla
authors: F
authors: F
authors: Bedogni
mesh_terms: D002858:Chromium Alloys; D023921:Coronary Stenosis / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D017239:Paclitaxel / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D012042:Registries; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents / Q000009:adverse effects*; D013927:Thrombosis / Q000453:epidemiology*; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage
chemical_list: D002858:Chromium Alloys; D007166:Immunosuppressive Agents; D050257:Tubulin Modulators; D017239:Paclitaxel; D020123:Sirolimus