Author + information
- Received October 29, 2003
- Revision received January 15, 2004
- Accepted January 19, 2004
- Published online June 2, 2004.
- Angela Hoye, MB, ChB*,
- Kengo Tanabe, MD*,
- Pedro A Lemos, MD*,
- Jiro Aoki, MD*,
- Francesco Saia, MD*,
- Chourmouzios Arampatzis, MD*,
- Muzaffer Degertekin, MD*,
- Sjoerd H Hofma, MD*,
- Georgios Sianos, MD, PhD*,
- Eugene McFadden, MB, ChB, FACC*,
- Willem J van der Giessen, MD, PhD*,
- Pieter C Smits, MD, PhD*,
- Pim J de Feyter, MD, PhD, FACC*,
- Ron T van Domburg, PhD* and
- Patrick W Serruys, MD, PhD, FACC*,* ()
- ↵*Reprint requests and correspondence:
Dr. Patrick W. Serruys, Department of Interventional Cardiology, Thoraxcentre Bd 404, Dr Molewaterplein 40, NL-3015 GD Rotterdam, the Netherlands.
Objectives The aim of this study was to assess sirolimus-eluting stent (SES) implantation for the treatment of chronic total coronary occlusions (CTO).
Background Long-term results after percutaneous coronary intervention (PCI) in the treatment of CTOs is hindered by a significant rate of restenosis and reocclusion. In the treatment of relatively simple nonocclusive lesions, SESs have shown dramatically reduced restenosis rates compared with bare metal stents (BMS), but whether these results are more widely applicable is unknown.
Methods From April 2002, all patients at our institution were treated with SES as the device of choice during PCI. During the first six months, 563 patients were treated solely with SES, with treatment of a de novo CTO in 56 (9.9%). This CTO cohort was compared with a similar group of patients (n = 28) treated in the preceding six-month period with BMS.
Results At one year, the cumulative survival-free of major adverse cardiac events was 96.4% in the SES group versus 82.8% in the BMS group, p < 0.05. At six-month follow-up, 33 (59%) patients in the SES group underwent angiography with a binary restenosis rate (>50% diameter stenosis) of 9.1% and in-stent late loss of 0.13 ± 0.46 mm. One patient (3.0%) at follow-up was found to have reoccluded the target vessel.
Conclusions The use of SESs in the treatment of chronic total coronary occlusions is associated with a reduction in the rate of major adverse cardiac events and restenosis compared with BMS.
- Received October 29, 2003.
- Revision received January 15, 2004.
- Accepted January 19, 2004.
- American College of Cardiology Foundation