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Moreno R, Baptista SB, Valencia J, Gomez-Menchero A, Bouisset F, Ruiz-Arroyo JR, Bento A, Besutti M, Jimenez-Valero S, Rivero-Santana B, Olhmann P, Santos M, Vaquerizo B, Cuissetm T, Lemoine J, Pinar E, Fiarresga A, Urbano C, Marliere S, Braga C, Amat-Santos I, Morgado G, Sarnago F, Telleria M, Van Belle E, Díaz-Fernandez J, Borrego JC, Amabile N, Meneveau N. OPTImized coronary interventions eXplaIn the bEst cliNical outcomEs (OPTI-XIENCE) study. Rationale and study design. Cardiovasc Revasc Med 2024; 59:93-98. [PMID: 37723011 DOI: 10.1016/j.carrev.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/29/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION Clinical events may occur after percutaneous coronary intervention (PCI), particularly in complex lesions and complex patients. The optimization of PCI result, using pressure guidewire and intracoronary imaging techniques, may reduce the risk of these events. The hypothesis of the present study is that the clinical outcome of patients with indication of PCI and coronary stent implantation that are at high risk of events can be improved with an unrestricted use of intracoronary tools that allow PCI optimization. METHODS AND ANALYSIS Observational prospective multicenter international study, with a follow-up of 12 months, including 1064 patients treated with a cobalt‑chromium everolimus-eluting stent. Inclusion criteria include any of the following: Lesion length > 28 mm; Reference vessel diameter < 2.5 mm or > 4.25 mm; Chronic total occlusion; Bifurcation with side branch ≥2.0 mm;Ostial lesion; Left main lesion; In-stent restenosis; >2 lesions stented in the same vessel; Treatment of >2 vessels; Acute myocardial infarction; Renal insufficiency; Left ventricular ejection fraction <30 %; Staged procedure. The control group will be comprised by a similar number of matched patients included in the "extended risk" cohort of the XIENCE V USA study. The primary endpoint will be the 1-year rate of target lesion failure (TLF) (composite of ischemia-driven TLR, myocardial infarction (MI) related to the target vessel, or cardiac death related to the target vessel). Secondary endpoints will include overall mortality, cardiovascular mortality, acute myocardial infarction, TVR, TLR, target vessel failure, and definitive or probable stent thrombosis at 1 year. IMPLICATIONS The ongoing OPTI-XIENCE study will contribute to the growing evidence supporting the use of intra-coronary imaging techniques for stent optimization in patients with complex coronary lesions.
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Affiliation(s)
- Raul Moreno
- Cardiology Department, La Paz University Hospital, Madrid, Spain.
| | | | | | | | | | | | | | | | | | | | - Patrick Olhmann
- Centres Hospitaliers et Universitaires of Strasbourg, France
| | - Miguel Santos
- Professor Doutor Fernando Fonseca Hospital, Portugal
| | | | | | | | | | | | | | | | | | | | | | | | | | - Eric Van Belle
- Centre Hospitalier Regional Universitaire de Lille, France
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El Amrawy AM, Camacho-Freire S, Gomez-Menchero A, Cardenal-Piris R, Diaz-Fernandez JF. Subclavian angioplasty during coronary interventions using radial approach. Kardiol Pol 2022; 80:1027-1031. [DOI: 10.33963/kp.a2022.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 06/20/2022] [Indexed: 11/14/2022]
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de la Torre Hernandez JM, Otaegui I, Subinas A, Gomez-Menchero A, Moreno R, Rondan J, Muñoz-Garcia E, Sainz-Laso F, Garcia Del Blanco B, Rumoroso JR, Diaz JF, Berenguer A, Gomez-Lara J, Zueco J. First-in-Man Evaluation of a Sirolimus-Eluting Stent With Abluminal Fluoropolymeric/Triflusal Coating With Ultrathin Struts by OCT at 9 Months' Follow-Up: The PROMETHEUS Study. Cardiovasc Revasc Med 2021; 32:18-24. [PMID: 33386256 DOI: 10.1016/j.carrev.2020.12.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES We sought to investigate stent healing and neointimal hyperplasia with ihtDEStiny drug-eluting stent (DES) by optical coherence tomography (OCT) examination conducted 9 months after implantation. BACKGROUND The currently used DES present certain features that have been linked separately to their better performance in terms of efficacy and safety. METHODS First-in-man, prospective and multicenter study including patients treated with ihtDEStiny stent undergoing OCT examination at 9 months follow up. The ihtDEStiny stent is a sirolimus eluting stent with an oval shape ultrathin struts (68 μm) and an abluminal coating of a fluoropolymer containing the antiplatelet agent triflusal. Primary endpoint was the percentage of obstruction of the in-stent volume by the neointima. RESULTS In 58 patients (63 lesions) in-stent late lumen loss was 0.11 ± 0.23 mm (95% CI 0.05-0.16) with only in 6% of stents being > 0.5 mm and in-segment binary stenosis was 1.6%. In OCT mean neointima volume obstruction was 10.5 ± 6.9% with a mean neointima thickness of 110.9 ± 89.8 μm. The proportion of uncovered struts was 2.5%, malapposed struts 1.1% and malapposed/uncovered struts 0.7% and no subclinical thrombi detected. Mean incomplete stent apposition area was 0.1 ± 0.1 mm2. At 12 months target lesion revascularization rate was 3% and no stent thrombosis was reported. CONCLUSIONS In this study the ihtDEStiny stent has shown a very low degree of neointimal proliferation associated with a low rate of uncovered/malapposed struts and total absence of subclinical thrombi at 9 months follow up.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Javier Zueco
- Hospital Marques de Valdecilla, IDIVAL, Santander, Spain
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Jimenez-Heffernan A, Aroui T, Sanchez De Mora E, Lopez-Martin J, Salgado C, Molina M, Cardenal R, Gomez-Menchero A, Isasti G. 185ST depression limited to recovery after combined adenosine and low-level exercise. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez137.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - T Aroui
- Hospital Juan Ramon Jimenez, Nuclear Medicine, Huelva, Spain
| | | | - J Lopez-Martin
- Hospital Juan Ramon Jimenez, Nuclear Medicine, Huelva, Spain
| | - C Salgado
- Hospital Juan Ramon Jimenez, Nuclear Medicine, Huelva, Spain
| | - M Molina
- Hospital Juan Ramon Jimenez, Nuclear Medicine, Huelva, Spain
| | - R Cardenal
- Hospital Juan Ramon Jimenez, Cardiology, Huelva, Spain
| | | | - G Isasti
- Hospital Juan Ramon Jimenez, Cardiology, Huelva, Spain
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Roa-Garrido J, Cardenal-Piris RM, El Amrawy AM, Gomez-Menchero A, Camacho Freire S, Diaz-Fernandez JF. Optical Coherence Tomographic Image Pattern of Metallic Bioresorbable Vascular Scaffold Restenosis. JACC Cardiovasc Interv 2018; 11:707-708. [DOI: 10.1016/j.jcin.2017.11.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 11/07/2017] [Indexed: 12/01/2022]
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