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Impact of overlapping drug‐eluting stents in patients undergoing percutaneous coronary intervention
Author(s) -
Chu William W.,
Kuchulakanti Pramod K.,
Torguson Rebecca,
Wang Betty,
Clavijo Leonardo C.,
Suddath William O.,
Pichard Augusto D.,
Satler Lowell F.,
Kent Kenneth M.,
Waksman Ron
Publication year - 2006
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20665
Subject(s) - medicine , percutaneous coronary intervention , myocardial infarction , stent , adverse effect , retrospective cohort study , surgery , cardiology , conventional pci , drug eluting stent
Abstract Background: Sirolimus‐eluting stent (SES) implantation for the treatment of single coronary lesions is proven to be effective and durable. However, the safety and efficacy of overlapping SES for the treatment of long lesions have not been well established. Objectives: We conducted a retrospective analysis to compare the clinical outcomes of overlapping versus nonoverlapping SES. Methods: Fifty‐five patients who received overlapping SES were compared with 39 patients who received nonoverlapping SES. Results: The baseline clinical and angiographic characteristics were balanced between the two study groups. The in‐hospital complications were similar between groups, except that non‐Q‐wave myocardial infarction was significantly higher in the Overlapping SES group when compared with the Nonoverlapping SES group (23.6% vs. 7.7%, P = 0.04). This higher rate of myonecrosis is due to periprocedural side branch compromises, including side branch narrowing, occlusion, and flow reduction. At 30 days and 6 months follow‐up, all clinical outcomes were similar between the study groups. In addition, the event‐free survival rate was similar between groups ( P = 0.87). Conclusions: The implantation of overlapping SES for the treatment of long, native coronary lesions is feasible and effective but is associated with an increased rate of periprocedural myonecrosis. This phenomenon is caused primarily by side branch compromises, but does not have any adverse impact on late clinical events. © 2006 Wiley‐Liss, Inc.