European Heart Journal Advance Access originally published online on April 7, 2005
European Heart Journal 2005 26(11):1056-1062; doi:10.1093/eurheartj/ehi191
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Immediate and mid-term outcomes of sirolimus-eluting stent implantation for chronic total occlusions
1EMO Centro Cuore Columbus and San Raffaele Hospital, 48 Via M. Buonarroti, 20145 Milan, Italy
2Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China
Received 31 October 2004; revised 31 January 2005; accepted 3 February 2005; online publish-ahead-of-print 7 April 2005.
* Corresponding author. Tel: +39 02 4812920; fax: +39 02 48193433. E-mail address: info{at}emocolumbus.it
See page 1049 for the editorial comment on this article (doi:10.1093/eurheartj/ehi243)
Aims To evaluate the outcomes of sirolimus-eluting stent (SES) implantation for the treatment of chronic total occlusion (CTO).
Methods and results We identified 122 patients who underwent revascularization in CTO lesions with SES from April 2002 to April 2004 (SES group). A control group was composed of 259 consecutive patients with CTO lesions treated with bare metal stents (BMS) in the 24 months immediately before the introduction of SES (BMS group). At 6-month follow-up, the cumulative rate of major adverse cardiac events (MACE) was 16.4% in the SES group and 35.1% in the BMS group (P<0.001). The incidence of restenosis was 9.2% in the SES group and 33.3% in the BMS group (P<0.001). The need for revascularization in the SES group was significantly lower, both target lesion revascularization (7.4 vs. 26.3%, P<0.001) and target vessel revascularization (9.0 vs. 29.0%, P<0.001). BMS implantation (HR: 2.97; 95% CI: 1.804.89; P<0.001), lesion length (>20 mm) (HR: 2.02; 95% CI: 1.372.99; P=0.0004), and baseline reference vessel diameter (>2.8 mm) (HR: 0.62; 95% CI: 0.420.92; P=0.02) were identified as predictors of MACE during 6-month follow-up.
Conclusion Compared with BMS, SES implantation in CTO lesions appears to be effective in reducing the incidence of restenosis and the need for revascularization at 6 months.
Key Words: Stents Occlusion Angioplasty Revascularization Restenosis
![]()
CiteULike
Connotea
Del.icio.us What's this?
Related articles in EHJ:
- Drug-eluting stents for chronic total occlusions make sense, but it is too early to close the discussion
- Erik Jørgensen and Henning Kelbæk
EHJ 2005 26: 1049-1051.[Extract] [FREE Full Text]
This article has been cited by other articles:
![]() |
A. S.P. Sharp, A. Latib, A. Ielasi, C. Larosa, C. Godino, M. Saolini, V. Magni, R. T. Gerber, M. Montorfano, M. Carlino, et al. Long-Term Follow-Up on a Large Cohort of "Full-Metal Jacket" Percutaneous Coronary Intervention Procedures Circ Cardiovasc Interv, October 1, 2009; 2(5): 416 - 422. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. A. Thompson, J. E. Jayne, J. F. Robb, B. J. Friedman, A. V. Kaplan, B. D. Hettleman, N. W. Niles, and W. L. Lombardi Retrograde Techniques and the Impact of Operator Volume on Percutaneous Intervention for Coronary Chronic Total Occlusions: An Early U.S. Experience J. Am. Coll. Cardiol. Intv., September 1, 2009; 2(9): 834 - 842. [Abstract] [Full Text] [PDF] |
||||
![]() |
H. Ishii, Y. Kumada, T. Toriyama, T. Aoyama, H. Takahashi, T. Amano, Y. Yasuda, Y. Yuzawa, S. Maruyama, S. Matsuo, et al. Aortic valvular calcification predicts restenosis after implantation of drug-eluting stents in patients on chronic haemodialysis Nephrol. Dial. Transplant., May 1, 2009; 24(5): 1562 - 1567. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. E. Kandzari, S. V. Rao, J. W. Moses, V. Dzavik, B. H. Strauss, M. J. Kutryk, C. A. Simonton, J. Garg, Y. Lokhnygina, G.B. J. Mancini, et al. Clinical and Angiographic Outcomes With Sirolimus-Eluting Stents in Total Coronary Occlusions: The ACROSS/TOSCA-4 (Approaches to Chronic Occlusions With Sirolimus-Eluting Stents/Total Occlusion Study of Coronary Arteries-4) Trial J. Am. Coll. Cardiol. Intv., February 1, 2009; 2(2): 97 - 106. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Valenti, A. Migliorini, U. Signorini, R. Vergara, G. Parodi, N. Carrabba, G. Cerisano, and D. Antoniucci Impact of complete revascularization with percutaneous coronary intervention on survival in patients with at least one chronic total occlusion Eur. Heart J., October 1, 2008; 29(19): 2336 - 2342. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. S.H. Cheng, J. B. Selvanayagam, M. Jerosch-Herold, W. J. van Gaal, T. D. Karamitsos, S. Neubauer, and A. P. Banning Percutaneous treatment of chronic total coronary occlusions improves regional hyperemic myocardial blood flow and contractility insights from quantitative cardiovascular magnetic resonance imaging. J. Am. Coll. Cardiol. Intv., February 1, 2008; 1(1): 44 - 53. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Colombo and A. Chieffo Drug-Eluting Stent Update 2007: Part III: Technique and Unapproved/Unsettled Indications (Left Main, Bifurcations, Chronic Total Occlusions, Small Vessels and Long Lesions, Saphenous Vein Grafts, Acute Myocardial Infarctions, and Multivessel Disease) Circulation, September 18, 2007; 116(12): 1424 - 1432. [Full Text] [PDF] |
||||
![]() |
H. K. Win, A. E. Caldera, K. Maresh, J. Lopez, C. S. Rihal, M. A. Parikh, J. F. Granada, S. Marulkar, D. Nassif, D. J. Cohen, et al. Clinical Outcomes and Stent Thrombosis Following Off-Label Use of Drug-Eluting Stents JAMA, May 9, 2007; 297(18): 2001 - 2009. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Prasad, C. S. Rihal, R. J. Lennon, H. J. Wiste, M. Singh, and D. R. Holmes Jr Trends in Outcomes After Percutaneous Coronary Intervention for Chronic Total Occlusions: A 25-Year Experience From the Mayo Clinic J. Am. Coll. Cardiol., April 17, 2007; 49(15): 1611 - 1618. [Abstract] [Full Text] [PDF] |
||||
![]() |
G. Di Giammarco, M. Pano, M. Giancane, A. Di Francesco, and M. Di Mauro Off-Pump Revascularization of Chronically Occluded Left Anterior Descending Artery Through Left Anterior Small Thoracotomy: Early and Late Angiographic and Clinical Follow-Up. Ann. Thorac. Surg., October 1, 2006; 82(4): 1446 - 1450. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. J. Suttorp, G. J. Laarman, B. M. Rahel, J. C. Kelder, M. A.R. Bosschaert, F. Kiemeneij, J. M. ten Berg, E. T. Bal, B. J. Rensing, F. D. Eefting, et al. Primary Stenting of Totally Occluded Native Coronary Arteries II (PRISON II): A Randomized Comparison of Bare Metal Stent Implantation With Sirolimus-Eluting Stent Implantation for the Treatment of Total Coronary Occlusions Circulation, August 29, 2006; 114(9): 921 - 928. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. T.L. Ong and P. W. Serruys Complete Revascularization: Coronary Artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention Circulation, July 18, 2006; 114(3): 249 - 255. [Full Text] [PDF] |
||||
![]() |
E. Jorgensen and H. Kelbaek Drug-eluting stents for chronic total occlusions make sense, but it is too early to close the discussion Eur. Heart J., June 1, 2005; 26(11): 1049 - 1051. [Full Text] [PDF] |
||||







