Self-Apposing Stents in Coronary Chronic Total Occlusions: A Pilot Study.

Autor: Elborae A; Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt. Electronic address: ahmed.elboraey@kasralainy.edu.eg., Hassan M; Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt., Meguid MA; Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt., Bakry K; Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt., Samir A; Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt., Brilakis E; Allina Health Minneapolis Heart Institute, Minneapolis, MN, USA., Kandil H; Department of Cardiovascular Medicine, Faculty of Medicine, Cairo University, Giza, Egypt., ElGuindy A; Department of Cardiology, Aswan Heart Centre, Magdi Yacoub Global Heart Foundation, Aswan, Egypt.
Jazyk: angličtina
Zdroj: Heart, lung & circulation [Heart Lung Circ] 2024 Apr; Vol. 33 (4), pp. 500-509. Date of Electronic Publication: 2024 Mar 05.
DOI: 10.1016/j.hlc.2024.01.014
Abstrakt: Objectives: This pilot study assessed the 12-month angiographic and clinical outcomes of self-apposing (SA) stents in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Background: Self-apposing (SA) stents may decrease incomplete strut apposition and stent strut coverage that are common after CTO PCI.
Methods: We compared 20 patients who underwent CTO PCI using SA drug-eluting stents (DESs) with 20 matched control patients who underwent CTO PCI using balloon-expandable (BE)-DESs. All patients were followed up clinically for 12 months and had coronary angiography with optical coherence tomography at the end of the follow-up period. The primary end points were stent strut malapposition and strut coverage. The secondary end point was composite major adverse cardiovascular events (MACEs) at 12 months.
Results: Both groups had high prevalence of diabetes mellitus, and most of the treated lesions were complex, with 62% having a J-CTO score of ≥3. All CTO PCI techniques were allowed for recanalisation, and 75% of the procedures were guided by intravascular ultrasound. At 12 months, the SA-DES group had fewer malapposed struts (0% [interquartile range (IQR) 0%-0%] vs 4.5% [IQR 0%-20%]; p<0.001) and uncovered struts (0.08% [IQR 0%-1.6%] vs 8.2% [IQR 0%-16%]; p<0.001). However, they showed significantly higher rates of MACEs due to clinically-driven target lesion revascularisation (45% vs 15%; p=0.038).
Conclusions: In this pilot study, compared with conventional BE-DESs, SA-DESs used in CTO PCI were associated with fewer malapposed and uncovered stent struts but also with significantly higher rates of in-stent restenosis and MACEs, mainly caused by clinically driven target lesion revascularisation.
Competing Interests: Conflicts of Interest There are no conflicts of interest to disclose.
(Copyright © 2024 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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