Impact of ultra‐thin struts on restenosis after chronic total occlusion recanalization: Insights from the randomized PRISON IV trial

Abstract

The present analysis suggests that the inferior performance of the ultra-thin hybrid-SES in CTO-PCI is particularly pronounced when smaller stent (≤3 mm diameter) are adopted, if compared with EES.

Impact of strut thickness and number of crown and connectors on clinical outcomes on patients treated with second‐generation drug eluting stent

“…Thickness of struts, despite ranging from 60 to 156 nm, can be clinically relevant because of its impact on restenosis and thrombosis. While it is well‐known that stents length and diameter are two independent predictors of ISR, 16–18 few data have been published on impact that platform and stent design have on clinical outcomes, especially regarding currently implanted DESs. Since the era of bare‐metal stents, preclinical evidence exists surrounding the role of stent strut geometry and thickness on parameters of safety and efficacy 19,20 and this is confirmed also for last generation DESs.…”

Elastic stent recoil in coronary total occlusions: Comparison of durable‐polymer zotarolimus eluting stent and ultrathin strut bioabsorbable‐polymer sirolimus eluting stent

“…Clinical, angiographic, and procedural characteristics were similar between the groups, except for the stent length that was higher in bp-SES group than in dp-ZES group (35 [30][31][32][33][34][35][36][37][38][39][40] mm vs. 34 [26][27][28][29][30][31][32][33][34][35][36][37][38] mm, p = .003) (Tables 1 and 2) as result of higher lesion length in patients treated with bp-SES than in patients treated with dp-ZES (25.95 mm [15.16-36.04] vs. 16.62 mm [9.67-27.24], p = .002) (Table 3).…”

“…were driven by the group of stent with diameter ≤ 3 mm with ultrathin struts of 60 μm and reduced radial strength. 31 However, the radial strength of the stent is not only related to the strut thickness, but also to material and three-dimensional mesh structure. [32][33][34] The stents evaluated in this study have both a cobalt-chromium alloy platform that provides high resistance to the elastic deformation and tensile strength.…”

Predictors of target lesion failure after treatment of left main, bifurcation, or chronic total occlusion lesions with ultrathin‐strut drug‐eluting coronary stents in the ULTRA registry

“…It has been questioned whether plaque scaffolding with ultrathin struts stents may be sufficient in the context of CTO that are usually rigid plaque‐loaded coronary lesions. For instance, in the PRISON IV trial that randomized 330 patients with successfully recanalized CTO to treatment with either Orsiro or Xience, the ultrathin‐strut Orsiro stent failed to meet the primary non‐inferiority endpoint of angiographic late lumen loss and showed a higher TLR rate 22 . A similar pattern was seen at 3‐year follow‐up, when the group of Orsiro‐treated patients showed a TLR rate of 11.5% and an incidence of major adverse cardiac events of 13.3% 23 .…”