Drug eluting stents: an updated meta-analysis of randomised controlled trials

Roiron, Cécile

doi:10.1136/hrt.2005.061622

Cited by 180 publications

(96 citation statements)

References 47 publications

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“…In the present study using the cutting balloon, the clinical restenosis rate was 16% at 1 year, despite the fact that aorto-ostial lesions are more prone to restenosis. The restenosis rate in our study was less than regular BMS implantation, which is 30% in most large series of BMS implantation 10 and 51% in a recent large study of aorto-ostial lesions. 6 However, in the present study, only 27% of the patients underwent angiographic follow-up, so the true angiographic restenosis rate could be higher.…”

Section: Discussioncontrasting

confidence: 59%

“…The rate of restenosis in our study (16%) approaches the rate of restenosis with DES of about 10%. 10 The reported restenosis rate of DES implantation of aorto-ostial lesions was 11% at 10 months. 6 Since there is concern about late thrombosis in DES, we suggest an alternative approach which would include cutting balloon and stent implantation with a BMS.…”

Section: Discussionmentioning

confidence: 99%

“…10 They have also been shown to be an appropriate treatment modality for aorta-ostial lesions. 6 However, emerging data suggests that DESs may increase the risk of late thrombosis, and increase morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

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Cutting Balloon Angioplasty and Stent Implantation for Aorto‐ostial Lesions: Clinical Outcome and 1‐year Follow‐up

Nassar

Gotsman

Gerganski

et al. 2009

Clinical Cardiology

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Background: Percutaneous interventions for aorto-ostial narrowing of native coronary arteries are challenging because of early elastic recoil after the procedure and the high restenosis rate. Cutting balloon angioplasty may reduce this complication. Hypothesis: The purpose of the study was to evaluate the clinical outcomes of cutting balloon angioplasty and stent implantation for aorto-ostial lesions with a 1-year clinical follow-up. Methods: All patients with aorto-ostial lesions in our laboratory underwent cutting balloon angioplasty and were followed for approximately 1 year. Results: Forty-eight patients underwent balloon angioplasty; 36 of whom had lesions in the ostial right coronary artery, and 12 of whom had lesions in the left main coronary artery (LMCA). Thirty-five patients (73%) had a stent implanted. Procedural success was achieved in all patients. The in-hospital rate of major adverse cardiac events (MACEs) was 2.1% because of the death of 1 patient following urgent bypass surgery. Mean clinical follow-up was 11.6 ± 7 month. Twelve patients (27%) required repeat coronary angiography, and restenosis was found in 7 patients (16%). Six patients (13.6%) had MACEs. Conclusions: Cutting balloon angioplasty in combination with bare metal stent (BMS) implantation has a good clinical outcome. This technique should be compared with implantation of drug-eluting stents (DESs) in a controlled study.

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Section: Discussioncontrasting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

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Cutting Balloon Angioplasty and Stent Implantation for Aorto‐ostial Lesions: Clinical Outcome and 1‐year Follow‐up

Nassar

Gotsman

Gerganski

et al. 2009

Clinical Cardiology

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“…Several meta-analyses revealed similar incidences of stent thrombosis between the two types of stents. 9,[21][22] The present study showed that implantation of a paclitaxel-eluting stent was a predictor of stent thrombosis. However, this result was not generalized because the number of patients was small and this study was not randomized.…”

Section: Discussionmentioning

confidence: 99%

Drug-Eluting Stent Thrombosis During Perioperative Period

et al. 2008

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SUMMARYRecently, the number of patients in whom a drug-eluting stent (DES) has recently been implanted and who need to undergo surgery or the most invasive procedure is increasing. However, there are limited data about the risk of perioperative thrombosis of DES. We evaluated the incidence and the risk factors of DES thrombosis during the perioperative period.Between January 2002 and December 2006, 141 patients who underwent surgery requiring discontinuation of a dual antiplatelet agent within 12 months of DES implantation were enrolled in one of the 3 study hospitals. We reviewed the clinical and procedural characteristics of the patients who developed stent thrombosis during the perioperative period.Stent thrombosis occurred in 7 cases (5.0%). The clinical outcomes of the patients with stent thrombosis were death in 5 cases and nonfatal MI in 2 cases. The patients with stent thrombosis were found to be older (64.2 ± 9.7 versus 71.7 ± 6.0 years, P = 0.045), to use a Taxus stent more frequently (36.6 versus 85.7%, P = 0.014), and to have a more prolonged period of discontinuation of clopidogrel (12.7 ± 10.0 versus 51.3 ± 33.2 days, P = 0.022) than the patients without stent thrombosis. Multivariate analysis revealed that 7 days or longer discontinuation of clopidogrel (OR 12.8, 95% CI 1.3-121.6, P = 0.021) and the use of a Taxus stent (OR 10.2, 95% CI 1.1-95.7, P = 0.043) were significant independent predictors of stent thrombosis during the perioperative period.A prolonged period of discontinuation of clopidogrel was associated with higher risk of stent thrombosis during the perioperative period. An earnest effort to continue antiplatelet therapy throughout the perioperative period can minimize the risk of stent thrombosis. (Int Heart J 2008; 49: 135-142)

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“…Early clinical studies in selected patients with noncomplex coronary lesions raised hopes that restenosis could be eliminated by DES (1). Subsequent trials in more complex lesions confirmed a substantial reduction in restenosis and target lesion revascularization rather than complete abolition of these adverse events (2). DES use rates subsequently escalated rapidly, and quickly reached 90% of total stent use in the United States and some European countries.…”

mentioning

confidence: 99%