TY - JOUR
T1 - First report of the use of long-tapered sirolimus-eluting coronary stent for the treatment of chronic total occlusions with the hybrid algorithm
AU - Zivelonghi, Carlo
AU - van Kuijk, Jan P.
AU - Nijenhuis, Vincent
AU - Poletti, Enrico
AU - Suttorp, Maarten J.
AU - van der Heyden, Jan A.S.
AU - Eefting, Frank D.
AU - Rensing, Benno J.
AU - ten Berg, Jurrien M.
AU - Azzalini, Lorenzo
AU - van den Brink, Floris S.
AU - Ribichini, Flavio
AU - Colombo, Antonio
AU - Henriques, José P.S.
AU - Agostoni, Pierfrancesco
N1 - Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Background: Coronary chronic total occlusions (CTO) usually coexist with diffusely diseased coronary segments proximal and/or distal to the CTO segment. During percutaneous treatment of CTO, multiple overlapping stents are often needed to treat these long lesions. Objectives: Aim of this study is to report the first use of long, tapered coronary sirolimus-eluting stents (SES) in this setting. Methods and results: This is a retrospective analysis of 100 consecutive patients undergoing CTO recanalization following the hybrid algorithm. Procedural success rate was 89% (11 failures). Among the successful cases, “conventional” drug-eluting stents(DES) were used in 40(44.9%) patients, while in 49(55%) patients long-tapered SES were attempted with a success rate of 98% (1 cross-over to regular stents). Total stent length in the long-tapered DES group was higher compared to the “conventional” stenting group (76 ± 28 mm vs 46 ± 22 mm, P <.001), with a similar total number of stent (1.6 ± 0.8 vs 1.9 ± 0.8). At quantitative coronary analysis, proximal and distal segment involvement was more extended in patients undergoing long-tapered stenting, with longer overall lesion length. No differences in periprocedural complications and clinical outcomes at a mean follow-up of 303 ± 179 days were observed. Conclusions: The use of long tapered coronary DES is technically feasible and safe for the percutaneous treatment of CTOs, especially for patients presenting with long lesions.
AB - Background: Coronary chronic total occlusions (CTO) usually coexist with diffusely diseased coronary segments proximal and/or distal to the CTO segment. During percutaneous treatment of CTO, multiple overlapping stents are often needed to treat these long lesions. Objectives: Aim of this study is to report the first use of long, tapered coronary sirolimus-eluting stents (SES) in this setting. Methods and results: This is a retrospective analysis of 100 consecutive patients undergoing CTO recanalization following the hybrid algorithm. Procedural success rate was 89% (11 failures). Among the successful cases, “conventional” drug-eluting stents(DES) were used in 40(44.9%) patients, while in 49(55%) patients long-tapered SES were attempted with a success rate of 98% (1 cross-over to regular stents). Total stent length in the long-tapered DES group was higher compared to the “conventional” stenting group (76 ± 28 mm vs 46 ± 22 mm, P <.001), with a similar total number of stent (1.6 ± 0.8 vs 1.9 ± 0.8). At quantitative coronary analysis, proximal and distal segment involvement was more extended in patients undergoing long-tapered stenting, with longer overall lesion length. No differences in periprocedural complications and clinical outcomes at a mean follow-up of 303 ± 179 days were observed. Conclusions: The use of long tapered coronary DES is technically feasible and safe for the percutaneous treatment of CTOs, especially for patients presenting with long lesions.
KW - chronic coronary total occlusion
KW - drug eluting stent
KW - stable angina
UR - http://www.scopus.com/inward/record.url?scp=85041661362&partnerID=8YFLogxK
U2 - 10.1002/ccd.27539
DO - 10.1002/ccd.27539
M3 - Article
C2 - 29411523
AN - SCOPUS:85041661362
SN - 1522-1946
VL - 92
SP - E299-E307
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 5
ER -