title: Clinical outcomes after PCI treatment of very long lesions with the XIENCE V everolimus eluting stent; Pooled analysis from the SPIRIT and XIENCE V USA prospective multicenter trials.
abstract: BACKGROUND
  Lesion length has been an important factor in predicting a worse outcome after percutaneous coronary interventions (PCI); however, the safety and efficacy of second-generation drug eluting stents in very long coronary lesions has not been validated in large scale randomized controlled trials.
  
  
  METHODS
  We performed a patient level pooled analysis of 13,266 patients undergoing planned overlapping stent treatment of very long coronary lesions with the XIENCE V everolimus eluting coronary stent system from 6 trials evaluating the XIENCE V stent (Spirit II, III, IV, V, Spirit Small Vessel and XIENCE V USA). Patients were divided into two cohorts, a very long lesion (VLL) group (lesions ≥35 mm) and a control group (lesions >24 to <35 mm). The primary outcome measures were Target Lesion Failure (TLF), Major Adverse Cardiac Events (MACE), and Academic Research Consortium (ARC) defined definite and probable stent thrombosis at 1 year.
  
  
  RESULTS
  A total of 13,266 patients were included in the pooled analysis of which 2.4% (323 patients with 328 total lesions) had a mean lesion length of 47.1 ± 13.7 mm in the VLL group which were compared to controls comprised of 3.6% of the cohort (482 patients with 500 total lesions) with mean lesion length of 28.1 ± 2.4 mm.There was no significant difference in the rates of TLF between the VVL and control groups (8.9 vs. 10%, P = 0.63), MACE (9.2 vs. 10%, P = 0.74) or stent thrombosis (1.6 vs. 1.5%, P = 0.92) at 1 year.
  
  
  CONCLUSIONS
  In the treatment of very long coronary lesions, the XIENCE V stent appears as safe and effective as percutaneous coronary interventions for long lesions. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Yale Cardiovascular Research Group, Yale University Medical Center, New Haven, Connecticut.
authors.forename: Georgios
authors.initials: G
authors.lastname: Bouras
authors.affiliation: Yale Cardiovascular Research Group, Yale University Medical Center, New Haven, Connecticut.
authors.forename: Sunny
authors.initials: S
authors.lastname: Jhamnani
authors.affiliation: Yale Cardiovascular Research Group, Yale University Medical Center, New Haven, Connecticut.
authors.forename: Vivian G
authors.initials: VG
authors.lastname: Ng
authors.affiliation: Yale Cardiovascular Research Group, Yale University Medical Center, New Haven, Connecticut.
authors.forename: Ido
authors.initials: I
authors.lastname: Haimi
authors.affiliation: Abbott Vascular, Santa Clara, California.
authors.forename: Vivian
authors.initials: V
authors.lastname: Mao
authors.affiliation: Abbott Vascular, Santa Clara, California.
authors.forename: Regina
authors.initials: R
authors.lastname: Deible
authors.affiliation: Abbott Vascular, Santa Clara, California.
authors.forename: Sherry
authors.initials: S
authors.lastname: Cao
authors.affiliation: Abbott Vascular, Santa Clara, California.
authors.forename: Krishnankutty
authors.initials: K
authors.lastname: Sudhir
authors.affiliation: Yale Cardiovascular Research Group, Yale University Medical Center, New Haven, Connecticut.
authors.forename: Alexandra J
authors.identifier: http://orcid.org/0000-0001-8002-7497
authors.initials: AJ
authors.lastname: Lansky
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology; D003328:Coronary Thrombosis / Q000209:etiology; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D000068338:Everolimus
keywords: drug-eluting stent; long coronary lesion; overlapped stents; percutaneous coronary intervention