Prevention of lesion recurrence in chronic total coronary occlusions by paclitaxel-eluting stents
In: Journal of the American College of Cardiology, , Heft 12, S. 2301-2306
Online
unknown
Zugriff:
OBJECTIVES The aim of this research was to assess the efficacy of paclitaxel-eluting stents in chronic total coronary occlusions (CTO). BACKGROUND Percutaneous coronary interventions for CTOs are characterized by a high target vessel failure rate. METHODS In 48 consecutive patients, paclitaxel-eluting stents (Taxus, Boston Scientific Corp., Natick, Massachusetts) were implanted after successful recanalization of a CTO (duration >2 weeks). Patients underwent an angiography after 6 months and were followed clinically for 12 months. They were compared with 48 lesion- and risk-matched patients with CTOs treated with bare metal stents (BMS). Primary clinical end point was the one-year incidence of major adverse cardiac events (MACE) (death, myocardial infarction, repeat revascularization); secondary end points were the rate of restenosis and re-occlusion. RESULTS In-hospital MACE was 4.2% with Taxus, and 2.1% with BMS (p = NS). The one-year MACE rate was 12.5% in the Taxus group, and 47.9% in the BMS group (p < 0.001), which was due to a reduced need for repeat revascularization. The angiographic restenosis rate was 8.3% with Taxus versus 51.1% with BMS (p < 0.001). There was only one late re-occlusion with Taxus (2.1%) as compared with 23.4% with BMS (p < 0.005). The late loss was reduced in the Taxus group by 84% as compared with BMS. All nonocclusive restenoses in the Taxus group were focal and successfully treated by implanting an additional Taxus stent. CONCLUSIONS The treatment of CTOs with a paclitaxel-eluting stent drastically reduces MACE and restenosis, and almost eliminates re-occlusion, which is typically frequent with BMS in CTOs. Chronic total coronary occlusion should be a preferred indication for drug-eluting stents.
Titel: |
Prevention of lesion recurrence in chronic total coronary occlusions by paclitaxel-eluting stents
|
---|---|
Autor/in / Beteiligte Person: | Figulla, Hans R. ; Prochnau, Dirk ; Krack, Andreas ; Werner, Gerald S. ; Betge, Stefan ; Schwarz, Gero |
Link: | |
Zeitschrift: | Journal of the American College of Cardiology, , Heft 12, S. 2301-2306 |
Veröffentlichung: | American College of Cardiology Foundation. Published by Elsevier Inc. |
Medientyp: | unknown |
ISSN: | 0735-1097 (print) |
DOI: | 10.1016/j.jacc.2004.09.040 |
Schlagwort: |
|
Sonstiges: |
|