title: Composite outcomes in 2.25-mm drug eluting stents: a systematic review.
abstract: BACKGROUND
  Coronary atherosclerosis often involves small-caliber coronaries, yet the safety and efficacy of 2.25-mm DES have been poorly defined, with a general lack of separation of 2.25 with 2.5-mm performance. No randomized head-to-head 2.25 mm DES studies have been reported. There are several single-arm prospective studies, and we aim to systematically review all published specific 2.25-mm data to estimate composite DES-specific performance and highlight current knowledge gaps.
  
  
  METHODS
  We performed a systematic literature search of PubMed, EMBASE, Web of Science and Cochrane database for clinical trials of 2.25-mm DES. Angiographic and composite clinical outcomes were compared with descriptive statistics.
  
  
  RESULTS
  2.25 mm-Paclitaxel (PES), sirolimus (SES), everolimus (EES) and platinum chromium EES DES-specific outcomes have been reported. Death at 12 months for SES, PES, EES and platinum chromium EES was 1.3%, 3.0%, 1.5%, and 4.4%. Rates of target vessel revascularization at 12 months for SES, PES, EES and platinum chromium EES were 5.7%, 13.3%, 8.8%, and 3.3%. Angiographic outcomes at 9 months to one year were as follows: mean late lumen loss (LLL) for SES, PES, and EES was 0.15 ± 0.11-mm, 0.28 ± 0.11-mm, and 0.16 ± 0.41-mm and mean diameter restenosis for SES, PES, and EES were 29.5 ± 6.2%, 34.7 ± 4.2%, and 20.9 ± 22.5%. Reported stent thrombosis rates for 2.25-mm DES were low ranging from 0% to 2.2% in up to 24-months of follow-up.
  
  
  CONCLUSIONS
  This systematic review summarizes and tabulates all available specific data on 2.25-mm DES. Based on our descriptive analysis, 2.25-mm DESs have a favorable safety and efficacy profile for the treatment of very small coronary lesions.
authors.affiliation: Department of Medicine, University of Arizona, 1501N Campbell Avenue, Tucson, AZ, 85724, USA.
authors.forename: Justin Z
authors.initials: JZ
authors.lastname: Lee
authors.affiliation: Department of Cardiovascular Diseases, University of Arizona, 1501N Campbell Ave, Tucson, AZ, 85724, USA.
authors.forename: Nirmal
authors.initials: N
authors.lastname: Singh
authors.affiliation: College of Medicine, University of Arizona, 1501N Campbell Ave, Tucson, AZ, 85724, USA.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Ortega
authors.affiliation: Department of Cardiovascular Diseases, University of Arizona, 1501N Campbell Ave, Tucson, AZ, 85724, USA.
authors.forename: See Wei
authors.initials: SW
authors.lastname: Low
authors.affiliation: Department of Cardiovascular Diseases, University of Arizona, 1501N Campbell Ave, Tucson, AZ, 85724, USA.
authors.forename: Uday
authors.initials: U
authors.lastname: Kanakadandi
authors.affiliation: Department of Cardiovascular Diseases, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.
authors.forename: F David
authors.initials: FD
authors.lastname: Fortuin
authors.affiliation: Department of Cardiovascular Diseases, University of Arizona, 1501N Campbell Ave, Tucson, AZ, 85724, USA.
authors.forename: Tom
authors.initials: T
authors.lastname: Lassar
authors.affiliation: Department of Cardiovascular Diseases, University of Arizona, 1501N Campbell Ave, Tucson, AZ, 85724, USA. Electronic address: klee@shc.arizona.edu.
authors.forename: Kwan S
authors.initials: KS
authors.lastname: Lee
mesh_terms: D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use*; D006801:Humans; D017239:Paclitaxel / Q000627:therapeutic use*; D020123:Sirolimus / Q000627:therapeutic use*
chemical_list: D000068338:Everolimus; D017239:Paclitaxel; D020123:Sirolimus
keywords: 2.25-mm; Drug eluting stents; Small coronary vessels