Seguimiento clínico del stent coronario largo no cónico de sirolimus en el mundo real en lesiones de novo.Registro Billar

  1. Enric Domingo Ribas 1
  2. Josep Guindo Soldevila 2
  3. Ramón Calviño Santos 3
  4. Imanol Otaegui 1
  5. Joan A. Gómez-Hospital 4
  6. Xavier Carrillo Suárez 5
  7. Juan Sánchez-Rubio Lezcano 6
  8. Leire Andraka Ikazuriaga 7
  9. Alfonso Torres 8
  10. Juan Manuel Casanova Sandoval 9
  11. Raymundo Ocaranza 10
  12. Javier León Jiménez 11
  13. Juan Francisco Muñoz 12
  14. R. Trillo Nouche 13
  15. Mónica Fuertes 14
  16. Bruno García del Blanco 1
  1. 1 Servicio de Cardiología, Hospital Universitari Vall d’Hebron, Barcelona, España
  2. 2 Servicio de Cardiología, Hospital Universitari Parc Tauli, Sabadell, Barcelona, España
  3. 3 Servicio de Cardiología, Complejo Hospitalario Universitario A Coruña, A Coruña, España
  4. 4 Servicio de Cardiología, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, España
  5. 5 Servicio de Cardiología, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
  6. 6 Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, España
  7. 7 Servicio de Cardiología, Hospital Universitario de Basurto, Bilbao, Bizkaia, España
  8. 8 Servicio de Cardiología, Hospital Txagorritxu HUA, Gasteiz, Araba, España
  9. 9 Servicio de Cardiología, Hospital Universitari Arnau de Vilanova, Valencia, España
  10. 10 Servicio de Cardiología, Hospital Lucus Augusti, Lugo, A Coruña, España
  11. 11 Servicio de Cardiología, Hospital Universitario Juan Ramón Jiménez, Huelva, España
  12. 12 Servicio de Cardiología, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, España
  13. 13 Servicio de Cardiología, Hospital Clínico Universitario de Santiago -CHUS, A Coruña, España
  14. 14 Servicio de Cardiología, Hospital del Mar, Barcelona, España
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Revista:
REC: Interventional Cardiology

ISSN: 2604-7276,  2604-7306

Ano de publicación: 2022

Volume: 4

Número: 1

Páxinas: 27-32

Tipo: Artigo

DOI: 10.24875/RECIC.M21000248 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Outras publicacións en: REC: Interventional Cardiology

Resumo

Introduction and objectives: Coronary lesions with stent overlapping are associated with higher neointimal proliferation that leads to more restenosis. Furthermore, the tapering of coronary arteries is a major challenge when treating long coronary lesions. This study attempted to assess the safety and clinical level of performance of long nontapered sirolimus-eluting coronary stent systems (> 36 mm) to treat long and diffused de novo coronary lesions in real-world scenarios. Methods: This was a prospective, non-randomized, multicentre study that included 696 consecutive patients treated with the long nontapered BioMime sirolimus-eluting coronary stent system in long and diffused de novo coronary lesions. The safety endpoint was major adverse cardiovascular events defined as a composite of cardiac death, myocardial infarction, clinically driven target lesion revascularization, stent thrombosis, and major bleeding at the 12-month follow-up. Results: Of a total of 696 patients, 38.79% were diabetic. The mean age of all the patients was 64.6 ± 14 years, and 80% were males. The indication for revascularization was acute coronary syndrome in 63.1%. A total of 899 lesions were identified out of which 742 were successfully treated with long BioMime stents (37 mm, 40 mm, 44 mm, and 48 mm). The cumulative incidence of major adverse cardiovascular events was 8.1% at the 12-month follow-up including cardiac death (2.09%), myocardial infarction (1.34%), and total stent thrombosis (0.5%). Conclusions: This study confirms the safety and good performance of long nontapered BioMime coronary stents to treat de novo coronary stenosis. Therefore, it can be considered a safe and effective treatment for long and diffused de novo coronary lesions in the routine clinical practice.

Referencias bibliográficas

  • 1. Tan CK, Tin ZL, Arshad MKM, et al. Treatment with 48-mm everolimus eluting stents:Procedural safety and 12-month patient outcome. Herz. 2019;44:419-424.
  • 2. Roach MR, MacLean NF. The importance of taper proximal and distal to Y-bifurcations in arteries. Front Med Biol Eng. 1993;5:127-133.
  • 3. Zubaid M, Buller C, Mancini GB. Normal angiographic tapering of the coronary arteries. Can J Cardiol. 2002;18:973-980.
  • 4. Sgueglia GA, Belloni F, Summaria F, et al. One-year follow-up of patients treated with new-generation polymer-based 38 mm everolimus-eluting stent:the P38 study. Catheter Cardiovasc Interv. 2015;85:218-224.
  • 5. Timmins LH, Meyer CA, Moreno MR, Moore JE, Jr. Mechanical modeling of stents deployed in tapered arteries. Ann Biomed Eng. 2008;36:2042-2050.
  • 6. Ellis SG, Holmes DR. Strategic approaches in coronary intervention. 2006:Lippincott Williams &Wilkins. P. 299-304.
  • 7. Raber L, Juni P, Loffel L, et al. Impact of stent overlap on angiographic and long-term clinical outcome in patients undergoing drug-eluting stent implantation. J Am Coll Cardiol. 2010;55:1178-1188.
  • 8. Mendis S, Thygesen K, Kuulasmaa K, et al. World Health Organization definition of myocardial infarction:2008- 09 revision. Int J Epidemiol. 2011;40:139-146.
  • 9. Cutlip DE, Windecker S, Mehran R, et al. Clinical end points in coronary stent trials:a case for standardized definitions. Circulation. 2007;115:2344-2351.
  • 10. Banka VS, Baker HA, 3rd, Vemuri DN, Voci G, Maniet AR. Effectiveness of decremental diameter balloon catheters (tapered balloon). Am J Cardiol. 1992;69:188-193.
  • 11. Kitahara H, Okada K, Kimura T, et al. Impact of stent size selection on acute and long-term outcomes after drug-eluting stent implantation in de novo coronary lesions. Circ Cardiovasc Interv. 2017;10:e004795.
  • 12. Sinha SK, Mahrotra A, Abhishekh NK, et al. Acute stent loss and its retrieval of a long, tapering morph stent in a tortuous, calcified lesion. Cardiol Res. 2018;9:63-67.
  • 13. Zivelonghi C, van Kuijk JP, Nijenhuis V, et al. First report of the use of long-tapered sirolimus-eluting coronary stent for the treatment of chronic total occlusions with the hybrid algorithm. Catheter Cardiovasc Interv. 201;5:1-9.
  • 14. Matchin YG, Atanesyan RV, Kononets EN, Danilov NM, Bubnov DS, Ageev FT. The first experience of using very long stents covered with sirolimus (4060 mm) in the treatment of patients with extensive and diffuse lesions of the coronary arteries. Kardiologiia. 2017;57:19-26.
  • 15. Timmins LH, Meyer CA, Moreno MR, Moore Jr. JE. Mechanical modeling of stents deployed in tapered arteries. Ann Biomed Eng. 2008;36:2042-2050.
  • 16. Xiang Shen, Yong-Quan Deng, Song Ji, Zhong-Min Xie. Flexibility behavior of coronary stents:the role of linker investigated with numerical simulation. J Mech Med Biol. 2017. https://doi.org/10.1142/S0219519417501123.
  • 17. Mushahwar SS, Pyatt JR, Lowe R, Morrison WL, Perry RA, Ramsdale DA. Clinical outcomes of long coronary stents:a single-center experience. Int J Cardiovasc Intervent. 2001;4:29-33.
  • 18. Sim HW, Thong EH, Loh PH, et al. Treating very long coronary artery lesions in the contemporary drug-eluting-stent era:single long 48 mm stent versus two overlapping stents showed comparable clinical results. Cardiovasc Revasc Med. 2020;21:1115-1118.
  • 19. Peter Jüni RL, Löffel L, Wandel S, et al. Impact of Stent Overlap on Angiographic and Long-Term Clinical Outcome in Patients Undergoing Drug-Eluting Stent Implantation. J Am Coll Cardiol. 2010;55:1178–1188.
  • 20. Lagache M, Coppel R, Finet G, et al. Impact of Malapposed and Overlapping Stents on Hemodynamics:A 2D Parametric Computational Fluid Dynamics Study. Mathematics. 2021;9:795.
  • 21. Jurado-Román A, Abellán-Huerta J, Antonio Requena J, et al. Comparison of Clinical Outcomes Between Very Long Stents and Overlapping Stents for the Treatment of Diffuse Coronary Disease in Real Clinical Practice. Cardiovasc Revasc Med. 2019;20:681-686.
  • 22. Patted SV, Jain RK, Jiwani PA, et al. Clinical Outcomes of Novel Long-Tapered Sirolimus Eluting Coronary Stent System in Real-World Patients With Long Diffused De Novo Coronary Lesions. Cardiol Res. 2018;9:350-357.
Fonte de datos: Dialnet