Nader Mankerious1, Rayyan Hemetsberger2, Hussein Traboulsi2, Ralph Toelg2, Mohamed Abdel-Wahab3, Gert Richardt2, Abdelhakim Allali2. 1. Heart Center, Segeberger Kliniken GmbH, Academic Teaching Hospital of the Universities of Kiel, Lübeck, and Hamburg, Am Kurpark 1, 23795, Bad Segeberg, Germany. nader.mankerious@gmail.com. 2. Heart Center, Segeberger Kliniken GmbH, Academic Teaching Hospital of the Universities of Kiel, Lübeck, and Hamburg, Am Kurpark 1, 23795, Bad Segeberg, Germany. 3. Cardiology Department, Heart Center Leipzig, University of Leipzig, Leipzig, Germany.
Abstract
OBJECTIVE: To compare Orsiro biodegradable-polymer sirolimus-eluting stent (Orsiro BP-SES) with durable-polymer everolimus-eluting stent (DP-EES) regarding target lesion failure (TLF) after rotational atherectomy (RA), with a focus on small stents (diameter ≤ 3 mm) where Orsiro BP-SES has 60 µm strut thickness, while DP-EES remains with 81 µm strut thickness. BACKGROUND: New-generation drug-eluting stent (DES) is superior to early-generation DES in all percutaneous coronary intervention (PCI) settings including RA. Recently, the Orsiro BP-SES was superior to a DP-EES in an all comer's population. METHODS: Among patients who underwent RA at a single center, 121 were treated with Orsiro BP-SES and 164 with DP-EES (Promus and Xience). Those treated with other stent types, presenting with acute myocardial infarction or had a chronic total occlusion were excluded. Incidence of TLF was assessed. RESULTS: After 2 years, the TLF rate in Orsiro BP-SES and DP-EES groups was 10% and 18%, respectively (adjusted HR 0.55, 95%CI 0.26-1.16, p = 0.115). The rate of TLF was significantly lower in small Orsiro BP-SES with ultra-thin struts as compared to DP-EES with the same diameters (adjusted HR 0.19, 95% CI 0.04-0.87, p = 0.032), driven by lower rates of clinically driven target lesion revascularization (log-rank p = 0.022). Age (p = 0.035), total stent length (p = 0.007) and diabetes mellitus (p = 0.011) emerged as independent predictors of TLF in the whole population. CONCLUSION: In the whole cohort, Orsiro BP-SES and DP-EES had comparable rates of long-term TLF after RA. In the small stent subgroup, the Orsiro BP-SES with ultra-thin struts showed significant lower rate of TLF at 2 years.
OBJECTIVE: To compare Orsiro biodegradable-polymer sirolimus-eluting stent (Orsiro BP-SES) with durable-polymer everolimus-eluting stent (DP-EES) regarding target lesion failure (TLF) after rotational atherectomy (RA), with a focus on small stents (diameter ≤ 3 mm) where Orsiro BP-SES has 60 µm strut thickness, while DP-EES remains with 81 µm strut thickness. BACKGROUND: New-generation drug-eluting stent (DES) is superior to early-generation DES in all percutaneous coronary intervention (PCI) settings including RA. Recently, the Orsiro BP-SES was superior to a DP-EES in an all comer's population. METHODS: Among patients who underwent RA at a single center, 121 were treated with Orsiro BP-SES and 164 with DP-EES (Promus and Xience). Those treated with other stent types, presenting with acute myocardial infarction or had a chronic total occlusion were excluded. Incidence of TLF was assessed. RESULTS: After 2 years, the TLF rate in Orsiro BP-SES and DP-EES groups was 10% and 18%, respectively (adjusted HR 0.55, 95%CI 0.26-1.16, p = 0.115). The rate of TLF was significantly lower in small Orsiro BP-SES with ultra-thin struts as compared to DP-EES with the same diameters (adjusted HR 0.19, 95% CI 0.04-0.87, p = 0.032), driven by lower rates of clinically driven target lesion revascularization (log-rank p = 0.022). Age (p = 0.035), total stent length (p = 0.007) and diabetes mellitus (p = 0.011) emerged as independent predictors of TLF in the whole population. CONCLUSION: In the whole cohort, Orsiro BP-SES and DP-EES had comparable rates of long-term TLF after RA. In the small stent subgroup, the Orsiro BP-SES with ultra-thin struts showed significant lower rate of TLF at 2 years.
Authors: Hideo Takebayashi; Yoshio Kobayashi; Gary S Mintz; Stéphane G Carlier; Kenichi Fujii; Takenori Yasuda; Issam Moussa; Roxana Mehran; George D Dangas; Michael B Collins; Edward Kreps; Alexandra J Lansky; Gregg W Stone; Martin B Leon; Jeffrey W Moses Journal: Am J Cardiol Date: 2005-02-15 Impact factor: 2.778
Authors: I Moussa; C Di Mario; J Moses; B Reimers; L Di Francesco; G Martini; J Tobis; A Colombo Journal: Circulation Date: 1997-07-01 Impact factor: 29.690
Authors: Emanuele Barbato; Didier Carrié; Petros Dardas; Jean Fajadet; Georg Gaul; Michael Haude; Ahmed Khashaba; Karel Koch; Markus Meyer-Gessner; Jorge Palazuelos; Krzysztof Reczuch; Flavio L Ribichini; Samin Sharma; Johann Sipötz; Iwar Sjögren; Gabor Suetsch; György Szabó; Mariano Valdés-Chávarri; Beatriz Vaquerizo; William Wijns; Stephan Windecker; Adam de Belder; Marco Valgimigli; Robert A Byrne; Antonio Colombo; Carlo Di Mario; Azeem Latib; Christian Hamm Journal: EuroIntervention Date: 2015-05 Impact factor: 6.534
Authors: T Dill; U Dietz; C W Hamm; R Küchler; H J Rupprecht; M Haude; J Cyran; C Ozbek; K H Kuck; J Berger; R Erbel Journal: Eur Heart J Date: 2000-11 Impact factor: 29.983
Authors: Lisette Okkels Jensen; Per Thayssen; Evald Høj Christiansen; Michael Maeng; Jan Ravkilde; Knud Nørregaard Hansen; Henrik Steen Hansen; Lars Krusell; Anne Kaltoft; Hans Henrik Tilsted; Klara Berencsi; Anders Junker; Jens Flensted Lassen Journal: J Am Coll Cardiol Date: 2016-02-23 Impact factor: 24.094
Authors: Mahesh V Madhavan; Madhusudhan Tarigopula; Gary S Mintz; Akiko Maehara; Gregg W Stone; Philippe Généreux Journal: J Am Coll Cardiol Date: 2014-02-12 Impact factor: 24.094