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First report of the use of long‐tapered sirolimus‐eluting coronary stent for the treatment of chronic total occlusions with the hybrid algorithm
Author(s) -
Zivelonghi Carlo,
van Kuijk Jan P.,
Nijenhuis Vincent,
Poletti Enrico,
Suttorp Maarten J.,
van der Heyden Jan A. S.,
Eefting Frank D.,
Rensing Benno J.,
ten Berg Jurrien M.,
Azzalini Lorenzo,
van den Brink Floris S.,
Ribichini Flavio,
Colombo Antonio,
Henriques José P. S.,
Agostoni Pierfrancesco
Publication year - 2018
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.27539
Subject(s) - medicine , sirolimus , stent , percutaneous coronary intervention , target lesion , surgery , retrospective cohort study , percutaneous , lesion , cardiology , radiology , myocardial infarction
Abstract Background Coronary chronic total occlusions (CTO) usually coexist with diffusely diseased coronary segments proximal and/or distal to the CTO segment. During percutaneous treatment of CTO, multiple overlapping stents are often needed to treat these long lesions. Objectives Aim of this study is to report the first use of long, tapered coronary sirolimus‐eluting stents (SES) in this setting. Methods and results This is a retrospective analysis of 100 consecutive patients undergoing CTO recanalization following the hybrid algorithm. Procedural success rate was 89% (11 failures). Among the successful cases, “conventional” drug‐eluting stents(DES) were used in 40(44.9%) patients, while in 49(55%) patients long‐tapered SES were attempted with a success rate of 98% (1 cross‐over to regular stents). Total stent length in the long‐tapered DES group was higher compared to the “conventional” stenting group (76 ± 28 mm vs 46 ± 22 mm, P < .001), with a similar total number of stent (1.6 ± 0.8 vs 1.9 ± 0.8). At quantitative coronary analysis, proximal and distal segment involvement was more extended in patients undergoing long‐tapered stenting, with longer overall lesion length. No differences in periprocedural complications and clinical outcomes at a mean follow‐up of 303 ± 179 days were observed. Conclusions The use of long tapered coronary DES is technically feasible and safe for the percutaneous treatment of CTOs, especially for patients presenting with long lesions.