Clinical and Angiographic Outcomes of Drug‐Eluting Stents in Patients With Large Vessel and Single Coronary Artery Lesion

Kim, Ung; Kim, Dong-Kie; Seol, Sang–Hoon; Yang, Tae–Hyun; Kim, Daekyung; Kim, Doo-Il; Kim, Dong-Soo; Lee, Sang‐Hee; Hong, Geu‐Ru; Park, Jong Seon; Shin, Dong‐Gu; Kim, Young-Jo; Cho, Yoon‐Kyoung; Kim, Hyungseop; Nam, Chang‐Wook; Hur, Seung‐Ho; Kim, Kwon-Bae

doi:10.1002/clc.20744

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…The drug-releasing profile of the SES was reported to be slower than that of the E-ZES stent 6) . Late loss and neointimal coverage were found to be similar between BMS and E-ZES 7,8) , whereas those of the SES were significantly less. These characteristics of E-ZES might contribute at least in part to the relatively rapid healing process observed in this case.…”

Section: Discussionmentioning

confidence: 82%

Optical Coherence Tomographic and Angioscopic Assessments of Arterial Healing in Coronary Artery Perforation After Implantation of Zotarolimus-Eluting Stent

Ichikawa

Kijima

2013

Int. Heart J.

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SummaryWe report the case of a 69-year-old male whose left circumflex coronary artery was perforated immediately after implantation of an Endeavor zotarolimus-eluting stent (E-ZES). Despite successful hemostasis by long balloon inflation, a coronary pseudoaneurysm remained at the E-ZES-implanted segment. Coronary angiography performed one year after the coronary perforation showed the pseudoaneurysm had disappeared. Simultaneous optical coherence tomography and coronary angioscopy revealed that stent struts of the E-ZES were fully covered with thick neointima. This is the first case report of a relatively rapid healing process for an E-ZES-related coronary pseudoaneurysm. (Int Heart J 2013; 54: 332-333)

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Section: Discussionmentioning

confidence: 82%

Optical Coherence Tomographic and Angioscopic Assessments of Arterial Healing in Coronary Artery Perforation After Implantation of Zotarolimus-Eluting Stent

Ichikawa

Kijima

2013

Int. Heart J.

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“…The present mean balloon diameter of the stent (near 3.50 mm) and postprocedural reference diameter (≥ 3.10 mm) indicated that large vessels were treated in the present cohort because the frequency of TLR after a bare-metal stent (BMS) was relatively low in these baselines. [21][22][23][24] Considering this background, the present study showed far better angiographic outcomes for BES compared to SES, because SES showed a prominent advantage for angiographic outcomes in large vessels compared to the contemporary BMS 23) and zotarolimus-eluting stent, 24) and because angiographic efficacy was equal in large vessels between SES and EES in terms of target vessel failure. 23) Accordingly, the present study is the first to show the efficacy of BES on midterm angiographic outcomes compared to SES after being used in a clinical setting.…”

Section: Discussionmentioning

confidence: 57%

Propensity-Score Matched Comparison of Midterm Angiographic Outcomes of Sirolimus- Versus Everolimus- and Biolimus-Eluting Stents for <i>De Novo</i> Coronary Stenosis

et al. 2017

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SummaryWe conducted propensity-score matched comparisons of midterm angiographic outcomes of sirolimus (SES) versus either everolimus-(EES) or biolimus-(BES) eluting stents after placements for coronary stenosis in a daily practice environment since previous randomized trials did not demonstrate the superiority of EES and BES over SES in terms of midterm angiographic outcomes.The present study was a non-randomized, retrospective, and lesion-based study, recruiting angiographically followed-up lesions within 550 days after successful and elective SES (n = 1793), EES (n = 1303), or BES (n = 324) placement for de novo native coronary stenosis during the period from August 2004 to January 2014 at 6 institutes. The endpoint, as an angiographic surrogate marker of clinical efficacy, was the distribution of in-stent follow-up percent diameter stenosis (%DS) which comprised the percentages of 1) follow-up %DS < 20 and 2) follow-up %DS > 50. Propensityscore matched analyses were conducted to adjust 21 baselines.In 1215 baseline adjusted lesions, the endpoints in the EES group [1) 74.1%, and 2) 4.6%] were significantly different from those in the SES group [57.9%; P < 0.001, 7.2%; P = 0.006, respectively). In 307 baseline adjusted lesions, the endpoints in the BES group [1) 80.5%, 2) 2.0%] were significantly different from those in the SES group [59.3%; P < 0.001, 2) 8.1%; P = 0.001, respectively].The present study is the first to confirm the superiority of midterm angiographic outcomes after the placement of EES and BES over SES for de novo coronary stenosis in a clinical setting. (Int Heart J 2017; 58: 320-327) Key words: Follow-up result, Angioplasty, Binary restenosis, Target lesion revascularization, Late luminal loss E verolimus-eluting stents (EES; Xience and Promus) have exhibited benefits associated with a favorable vascular response compared to sirolimus-eluting stents (SES; Cypher BxV and Select+), owing to their advanced drug-eluting stent (DES) technology that consists of the revised thin and flexible stent platform, anti-thrombogenic fluoropolymer, and drug. 1,2) The biolimus-eluting stent (BES; Nobori) also showed a better midterm intravascular response compared to SES, owing to its properties such as being a biodegradable polymer and the highest lipophilicity among the limus analogues. 3,4) However, despite these advanced aspects of EES and BES compared with the former evidence-based first generation "-limus" DES, that is, SES, prospective randomized trials have not demonstrated significantly better midterm angiographic outcomes for either EES 5,6) or BES 7,8) in terms of binary in-stent restenosis, TLR, or mean magnitude of in-stent late luminal loss compared to those of SES.In the present study, we conducted a retrospective comparison to examine the impact of the advances in coronary stent technology, represented by improved intravascular and pathological findings of either EES or BES over SES 1-4) on the overall midterm angiographic outcomes. For this purpose, 3420 lesions angiographically followed-up ...

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“…Where the two stent varieties do seem to differ is in late loss, an end point not included in this 12-month outcome meta-analysis. Zotarolimus-eluting stents have been documented to demonstrate greater late loss than paclitaxel-eluting stents [ 2 , 3 , 8 ]. This study, however, did not find an increase in stent thrombosis with zotarolimus-eluting stents.…”

Section: Discussionmentioning

confidence: 99%

“…A total of seven end points were extracted from five studies [ 2 – 6 ]. End points studied were myocardial infarction (MI), major adverse cardiac events (MACE), cardiac death, all-cause death, stent thrombosis, target vessel revascularization, and target lesion revascularization.…”

Section: Methodsmentioning

confidence: 99%

Comparison of 12-Month Outcomes with Zotarolimus- and Paclitaxel-Eluting Stents: A Meta-Analysis

et al. 2011

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Revascularization after myocardial infarction is often achieved via percutaneous coronary intervention, which often entails stenting. Drug-eluting stents have shown benefits over bare metal stents in this setting, and a variety of drug-eluting stents are now available, including sirolimus-, paclitaxel-, and zotarolimus-eluting stents. There are studies that have compared the various drug-eluting stents and this meta-analysis pools data comparing 12-month clinical outcomes of zotarolimus- and paclitaxel-eluting stents. End points studied were myocardial infarction, major adverse cardiac events, cardiac death, all-cause death, stent thrombosis, target vessel revascularization, and target lesion revascularization.There was a statistically significant reduction in risk of myocardial infarction (odds ratio, 0.250, confidence interval, 0.160 to 0.392) and statistically insignificant reductions in major adverse cardiac events (odds ratio, 0.813, confidence interval, 0.656 to 1.007), cardiac death (odds ratio, 0.817, confidence interval, 0.359 to 1.857), all cause death (odds ratio, 0.820, confidence interval, 0.443 to 1.516), and target lesion revascularization (odds ratio, 0.936, confidence interval 0.702 to 1.247). There was a statistically significant increase in target vessel revascularization (odds ratio, 1.336, confidence interval, 1.003 to 1.778) and a statistically insignificant increase in stent thrombosis (odds ratio, 1.174, confidence interval, 0.604 to 2.280). These findings are similar to the individual studies although other studies have noted increased late loss with zotarolimus-eluting stents and this current data associated with late loss should be kept in mind when makimg clinical decisions regarding sent selection.

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Clinical and Angiographic Outcomes of Drug‐Eluting Stents in Patients With Large Vessel and Single Coronary Artery Lesion

Cited by 3 publications

References 19 publications

Optical Coherence Tomographic and Angioscopic Assessments of Arterial Healing in Coronary Artery Perforation After Implantation of Zotarolimus-Eluting Stent

Optical Coherence Tomographic and Angioscopic Assessments of Arterial Healing in Coronary Artery Perforation After Implantation of Zotarolimus-Eluting Stent

Propensity-Score Matched Comparison of Midterm Angiographic Outcomes of Sirolimus- Versus Everolimus- and Biolimus-Eluting Stents for <i>De Novo</i> Coronary Stenosis

Comparison of 12-Month Outcomes with Zotarolimus- and Paclitaxel-Eluting Stents: A Meta-Analysis

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