Document Detail


Two-year outcome of the use of paclitaxel-eluting stents in aorto-ostial lesions.
MedLine Citation:
PMID:  18031845     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous treatment of stenoses involving aorto-ostial lesions is technically demanding and has been associated with lower procedural success and poorer clinical and angiographic outcomes when compared with non-ostial lesions. This study evaluated the immediate and long-term (2-year) outcome of aorto-ostial stenoses treated with paclitaxel-eluting stents (PES). METHODS: From February 2003 to December 2004, a total of 76 consecutive patients with 76 lesions underwent percutaneous intervention with PES for aorto-ostial lesions (right coronary artery, 37; left main, 26; saphenous vein graft, 13). All patients were clinically followed for the occurrence of major adverse cardiac events (MACE), defined as cardiac death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR) or target vessel revascularization (TVR). RESULTS: All stents (1.7/lesion) were successfully deployed. Three lesions (3.9%) were pre-treated with debulking devices. Thirty-seven lesions (48.7%) were post-dilated with non-compliant balloons (balloon/artery ratio, 1.2). Stents were positioned protruding into the aortic lumen in 29 lesions (38.2%). Cumulative 2-year event-free survival was 68.4%. There was one angiographically-proven stent thrombosis occurring 427 days after TLR for restenosis after the index procedure. The restenosis rate at 7 months (median) was 20.0% and in-stent late lumen loss was 0.48 mm in 40 patients with angiographic follow-up. CONCLUSIONS: Utilization of PES in this complex lesion subset is feasible and associated with favorable angiographic results at 7 months. However, the gradual increase in later events up to 2 years suggests that aorto-ostial disease remains problematic even in the era of drug-eluting stents.
Authors:
Keiichi Tsuchida; Joost Daemen; Shuzou Tanimoto; Héctor M García-García; Neville Kukreja; Sophia Vaina; Andrew T L Ong; Georgios Sianos; Peter P T de Jaegere; Ron T van Domburg; Patrick W Serruys
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-11-26
Journal Detail:
Title:  International journal of cardiology     Volume:  129     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2010-02-23     Completed Date:  2010-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  348-53     Citation Subset:  IM    
Affiliation:
Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / trends
Coronary Artery Disease / drug therapy*,  mortality,  radiography*
Coronary Restenosis / drug therapy,  mortality,  radiography
Drug-Eluting Stents* / trends
Female
Follow-Up Studies
Humans
Male
Middle Aged
Paclitaxel / administration & dosage*
Survival Rate / trends
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
33069-62-4/Paclitaxel

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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