Biodegradable polymer versus second-generation durable polymer drug-eluting stents in patients with coronary artery disease: A meta-analysis

Procedural safety and outcome of ultrathin strut stents (<60 μm) in the management of very long coronary artery stenosis (>30 mm) - A retrospective real world study

BACKGROUND

The ultrathin strut stents (<60 μm) are new in the current stents technology. This technology has assured to have less stent thrombosis, restenosis and better deliverability. Still there is lacking data of using long ultrathin strut stents in very long segment coronary artery disease (>30 mm).

AIM

The aim of this retrospective study was to assess the procedural safety and outcome of using ultrathin strut stents in very long segment coronary artery lesion.

METHODS

In this retrospective analysis, we have enrolled those patients who had an implant of more than 30 mm length of ultrathin strut stents (Evermine 50^TM and Tetrilimus stents) in real world patients as per physician discretion. Here, we enrolled 156 patients which included both acute coronary syndrome (ACS) and stable ischemic heart disease (SIHD). The endpoint of this study was to evaluate the immediate procedural success and short to intermediate term follow-up of all-cause mortality and clinically driven target lesion revascularization.

RESULTS

Out of these 156 patients (mean age- 61.2 +/- 10.4 years; male: 114), in 12 patients, these long stents couldn't be delivered. In rest 144 patients, 147 ultrathin strut stents were implanted. In about 56% patients were hypertensive and 48% patients were diabetic. About 63% patients had ACS and rest 37% patients had SIHD. The mean duration of follow up was 8.4 +/- 13.9 months. Average stent length and diameter were 39.5 +/- 5.9 mm and 3.03 +/- 0.4 mm, respectively. There was no acute or sub-acute stent thrombosis and no procedural complication. Five patients died during follow-up (all-cause mortality) and rest are all symptoms free. There were no statistical significant differences seen among the stent types.

CONCLUSION

Ultrathin strut stents can be considered for stenting in long segment coronary artery stenosis with reasonably good procedural success rate and have good clinical outcome, but needs further large randomized trial before using in this particular clinical condition. Both the stent designs have similar clinical outcome and procedural success.

Twelve-month comparative analysis of clinical outcomes using biodegradable polymer-coated everolimus-eluting stents versus durable polymer-coated everolimus-eluting stents in all-comer patients

Aim

The purpose of the present study was to examine whether clinical differences exist between the biodegradable polymer (BDP)–coated Tetrilimus everolimus-eluting stent (EES) and the durable polymer (DP)–coated Xience EES by comparing the major adverse cardiac event (MACE) rate at 12 months in all-comer patients.

Methods

This study was designed as a multicentre, observational, retrospective, investigator-initiated study between January 2016 and October 2016. Two hundred thirteen patients who underwent percutaneous coronary intervention (PCI) with the BDP-EES were compared with 204 patients who underwent PCI with the DP-EES, irrespective of lesion complexity, comorbidities and acute presentation. The primary end point was MACE defined as a composite of cardiac death, myocardial infarction and target lesion revascularization.

Results

Baseline clinical and lesion characteristics of both the groups were similar, although the BDP-EES group had a significantly higher number of patients with diabetes mellitus (39.9% vs. 30.4%; p = 0.042) and type C lesion (67.4% vs. 48.1%; p < 0.001) than the DP-EES group. The 12-month MACE rate was 4.2% for the BDP-EES group versus 4.9% for the DP-EES group (p = 0.740). Mortality was lower in the BDP-EES group than in the DP-EES group (0.9% vs. 2.0%; p = 0.441).

Conclusion

The present comparative analysis shows that the BDP-coated Tetrilimus EES was as safe and effective as the DP-coated Xience EES during the 12-month follow-up period despite complex lesion characteristics.