Clinical Outcomes of Novel Long-Tapered Sirolimus-Eluting Coronary Stent System in Real-World Patients With Long Diffused <i>De Novo</i> Coronary Lesions

Patted, Suresh; Jain, Rajendra K.; Jiwani, P. A.; Suryavanshi, Satish; Raghu, T.R.; Raveesh, Hema; Rajalakshmi, S.; Thakkar, Ashok; Turiya, Prakash Kumar; Desai, Priyanka; Patted, Anmol Suresh; Sharma, Kamal

doi:10.14740/cr795

Cited by 14 publications

(15 citation statements)

References 14 publications

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“…The BioMime Morph is a biodegradable polymer-based sirolimus-eluting novel tapered stent with the ultra-thin strut of 65 m of cobalt chromium platform. Studies have shown that the usage of tapered stents in daily clinical practice showed good apposition and coronary flow without any complications [ 6 , 7 ]. Very few cases documented the feasibility of using long-tapered stents in diseases involving the left main [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that the usage of tapered stents in daily clinical practice showed good apposition and coronary flow without any complications [ 6 , 7 ]. Very few cases documented the feasibility of using long-tapered stents in diseases involving the left main [ 6 ]. Here, we report the case of complex triple vessel disease with left main involvement and CTO of RCA which was managed successfully with long-tapered BioMime Morph stents.…”

Section: Discussionmentioning

confidence: 99%

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Use of BioMime Morph stent in treating left main triple vessel disease: a case report

et al. 2020

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Background Diffuse long coronary lesions require long overlapping stents which produce less than optimal long-term results. Sizing of long stents becomes difficult owing to tapering of coronaries and overlapping with excessive metal which makes restenosis a nagging problem on long-term follow-up. The optimal stent sizing becomes even more important when left main (LM) needs to be treated along with left ascending artery (LAD) or left circumflex artery (Lcx). The chronic total occlusions (CTO) represent other complex diffuse coronary lesions which not only require higher expertise and better hardware but also usually long lengths of overlapping stents. The long-tapered sirolimus-eluting stent system (BioMime Morph) has been successfully used in long diffuse lesions in individual coronaries including CTO but the use of the same in LM-LAD/LM-Lcx diffuse lesions has not been explored well where its tapered design can really be favourable. Case presentation We here present a case of a 51-year-old hypertensive male presented with NSTEMI and angiography showing left main triple vessel disease with CTO of right coronary artery (RCA). We successfully stented the LM-LAD and RCA (staged) using a long-tapered BioMime Morph system. IVUS was used for optimising the LM-LAD stent. At 6 months follow-up, the patient was doing well on double anti-platelets. Conclusion Complex coronary disease, involving the left main and LAD diffusely and CTO of RCA, can be well managed by using a single long-tapered stents thereby avoiding multiple stenting strategy. The stents with decremental diameter will provide better adaptation to the vessel size and their natural tapering. The usage of intravascular imaging helps in better optimisation of stents

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of BioMime Morph stent in treating left main triple vessel disease: a case report

et al. 2020

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“…Current strategies to treat TCALs include overlapped stenting with multiple short stents [26][27][28], single stenting with a conventional long tubular stent [29,30], or single stenting with a tapered long stent [18][19][20][21][22][23].…”

Section: Controversial Outcomes Of Current Stenting Strategies For Tcalsmentioning

confidence: 99%

“…To overcome this dilemma, conventional overlapped stenting (COS) offers an option but may increase risks of in-stent restenosis or thrombosis, as well as the therapeutic cost [11][12][13][14][15][16][17]. Recently, a long tapered stent customized for TCALs has been developed but is not yet extensively used [18][19][20][21][22][23]. Accordingly, we proposed a modified single stenting (MSS) by using a conventional long stent for TCAL treatment.…”

Section: Introductionmentioning

confidence: 99%

Comparison of standard versus modified stenting technique for treatment of tapered coronary artery lesions

Ke¹,

He²,

Cai³

et al. 2021

Reviews in Cardiovascular Medicine

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Tapered coronary artery lesions (TCALs) are often seen clinically, optimal stenting of TCALs remains challengeable. This study sought to compare clinical outcomes between the modified single stenting (MSS) and conventional overlapped stenting (COS) in treatment of TCALs. 150 patients were treated with MSS (MSS group), another 150 patients were matched with propensity score matching from 5055 patients treated with COS (COS group). Quantitative coronary angiography was performed to measure minimal lumen diameter (MLD), late lumen loss (LLL). The primary endpoint was immediate angiographic success, one-year cumulative major cardiac adverse events (MACEs) composing cardiac death, target vessel myocardial infarction (TVMI), target lesion/vessel revascularization (TLR/TVR) or stent thrombosis (ST). Post-procedural in-stent MLD (2.96 ± 0.34 versus 3.08 ± 0.33, P = 0.004) was smaller and diameter stenosis (11.7 ± 4.0% versus 9.0 ± 4.8%, P = 0.003) was higher in MSS group than COS group. At 1-year follow-up, in-stent MLD (2.76 ± 0.38 mm versus 2.65 ± 0.60 mm, P = 0.003) was reduced, LLL (0.20 ± 0.26 mm versus 0.42 ± 0.48 mm, P = 0.001), diameter stenosis (24.02 ± 20.94% versus 19.68 ± 11.75%, P = 0.028) and binary restenosis (18.7% versus 10.0%, P = 0.047) were increased in COS group. Angiographic success (96.7% versus 98.0%, P = 0.723) was similar between MSS group and COS group. At 1-year, the cumulative MACEs (12.0% versus 22.7%, P = 0.022) and TLR/TVR (10.0% versus 18.7%, P = 0.047) were reduced in MSS group as compared to COS group, there was no difference in cardiac death, TVMI and ST between the groups. Compared to conventional overlapped stenting, modified single stenting for TCALs is associated with similar angiographic success, fewer one-year cumulative MACEs and less treatment cost.

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“…It is especially useful for long lesions where the use of tapered single coronary stent may provide better vessel adaptation and superior long-term outcomes apart from curtailing the financial cost. A few studies evaluating the efficacy of this novel concept have found encouraging results (6,7), In this study, we aimed to study the peri-procedural safety, and one-year outcomes of patients undergoing treatment with the BioMime Morph SES in the high-risk Indian population.…”

Section: Introductionmentioning

confidence: 99%

One-year outcomes of novel BioMime Morph tapered stent in long and multiple coronary artery lesions

Sharma¹,

Uppal²,

Panda³

et al. 2021

The Anatolian Journal of Cardiology

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Objective: Even with the immense progress achieved in the field of percutaneous coronary interventions (PCIs), treatment of diffuse long atherosclerotic coronary artery disease continues to remain a challenge for durable outcomes. The downstream reduction in diameter along the lesion length of a coronary artery may compel the cardiologist to use either 2 overlapping stents of different diameters or a single long stent leading to stent-vessel mismatch at the edges. Recently, Meril Life Sciences Pvt. Ltd., India, has introduced a long-tapered sirolimus-eluting stent (SES) system, BioMime Morph, which conforms to the normal tapered geometry of coronary arteries along with adequate lesion coverage. In this study, we aimed to provide real world experience regarding the safety and efficacy of the BioMime Morph SES over a follow-up of one year. Methods: This was a single center, retrospective study involving 172 participants who underwent PCI with the BioMime Morph SES. Mean length of the target lesion was 34.4±10.4 mm, and mean stent length was 53.2±8.7 mm. The most frequent revascularized vessel was the left anterior descending artery (LAD) in 97 lesions (54.4%). Results: Major adverse cardiac events (MACE) (defined as a composite of target vessel myocardial infarction, target lesion revascularization, and death due to a cardiac cause) at 1, 6, and 12 months were seen in 4 (2.3%), 7 (4.0%), and 8 (4.7%) patients, respectively. Overall, 5 cardiac deaths and 2 definite stent thrombosis were observed in the study. Conclusion:The study suggests that the novel BioMime Morph SES is an effective and a safe option for PCI in the treatment of long diffuse atherosclerotic lesions.

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Clinical Outcomes of Novel Long-Tapered Sirolimus-Eluting Coronary Stent System in Real-World Patients With Long Diffused De Novo Coronary Lesions

Cited by 14 publications

References 14 publications

Use of BioMime Morph stent in treating left main triple vessel disease: a case report

Use of BioMime Morph stent in treating left main triple vessel disease: a case report

Comparison of standard versus modified stenting technique for treatment of tapered coronary artery lesions

One-year outcomes of novel BioMime Morph tapered stent in long and multiple coronary artery lesions

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