Author + information
- Joshua Ping Yun Loh,
- Rajiv Ananthakrishna,
- Hui Wen Sim,
- Poay Huan Loh,
- Edgar Tay,
- Koo Chan,
- Mark Chan,
- Ronald C.H. Lee,
- Adrian Low and
- Huay-Cheem Tan
Background: There is limited data on optimal treatment of coronary artery stenosis in small calibre vessels. Small 2 mm drug eluting stents (DES) are now commercially available. The clinical outcomes of small vessel stenting with current generation 2 mm DES have not been evaluated.
Methods: This is a prospective, single-centre, single- arm, all-comers registry study of patients with de novo coronary stenosis who underwent implantation of 2 mm DES from July 2014 to August 2015. The primary outcome was target lesion failure (TLF), defined as the combination of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularisation (TLR) at one- year.
Results: A total 111 patients with 131 stents (XIENCE Xpedition SV: 95, Resolute Onyx: 36) implanted were analysed. The mean age was 61.6 years. Patients with diabetes mellitus consisted of 54.9% of the study population, and 62.2% presented with acute myocardial infarction. Majority of the treated lesions were complex (ACC/AHA type B2/C: 76.7%). The target vessel for stenting was a main vessel in 77.8% and a branch vessel in 22.2%. The mean lesion length was 19.5 ±7.3 mm, and the mean number of stents implanted per patient was 1.2 ± 0.5. Intra-vascular imaging was used in 9.9% of the patients. The primary end point of TLF at one-year was 8.1%. Rates of cardiac mortality, target vessel myocardial infarction and TLR were 2.7%, 4.5% and 5.4%, respectively at one-year. The incidence of definite / probable stent thrombosis was 2.7% at 30 days and 3.6% at one-year, with 3 of the 4 cases occurring within 30 days.
Conclusions: Preliminary real world outcomes of 2 mm DES showed higher than expected rates of TLF and stent thrombosis at one-year. Further evaluation is warranted to confirm this real world observation.
Poster Contributions Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Intervention: Drug Eluting Stent & Scaffolds
Abstract Category: 21. Interventional Cardiology: Coronary Intervention: Devices
Presentation Number: 1240-132
- 2017 American College of Cardiology Foundation