Percutaneous coronary intervention in aorto-ostial lesions. Immediate and medium-term results in a real world cohort

Jurado-Román, Alfonso; López-Melgar, Beatriz; Garcı́a-Tejada, Julio; Hernández-Hernández, Felipe; Velázquez-Martín, María Teresa; Albarrán-González-Trevilla, Agustín; Rubio-Alonso, Belén; Díaz-Antón, Belén; Andreu-Dussac, Javier; Tascón-Pérez, Juan

doi:10.1016/j.ijcard.2013.04.093

Cited by 1 publication

(2 citation statements)

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“…Long-term outcomes of PCI in aorto-ostial coronary lesions with DES is less favorable compared to the results of PCI in non-ostial lesions [5,6]. Several approaches, such as intravascular imaging and implantation of a stent with high radial strength [10], may improve the long-term success after PCI in this setting.…”

Section: Discussionmentioning

confidence: 99%

“…Despite implanting drug eluting stents (DES), restenosis remains a relevant clinical problem with high target lesion revascularization (TLR) rates one year after implantation of first-generation DES (12-28%) in right coronary ostial lesions [3,4]. Using newer generation DES, two registries reported TLR rates of around 12% in such lesions [5,6] which remains 3-4 times higher than in non-ostial lesions [7]. A recent analysis from an international multicenter registry showed that the use of newer-generation DES was associated with lower target lesion failure (TLF) rates whereas stent under-expansion was the strongest predictor for TLF, increasing the risk by 10-fold [8].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Outcomes after Additional Dynamic Renal® Stent Implantation for Stent Recoil in Ostial Coronary Lesions

Abdulrahman¹,

Mashayekhi²,

Tajti³

et al. 2020

JCM

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Background: Interventional treatment of aorto-ostial coronary stenoses is limited by stent recoil and suboptimal angiographic results, leading to restenosis and frequent re-interventions. As a potential bail-out strategy for stent recoil, implantation of an additional stent to increase radial force has been reported. Thus, we sought to investigate clinical outcomes after additional implantation of a Dynamic Renal® stent (DRS), a non-coronary; bare-metal stent with very high radial force, in aorto-ostial coronary stenoses. Methods: Patients treated by implantation of DRSs for stent recoil in the ostial right coronary artery or the left main stem were identified from the hospital database. Baseline clinical and procedural characteristics were compared to patients who underwent re-intervention for in-stent-restenosis in similar segments by either implantation of conventional drug-eluting stents (DES) or paclitaxel-coated balloons (PCB). Clinical follow-ups were performed up to three years following re-intervention with the assessment of death, target lesion reintervention (TLR), and major adverse cardiac events (MACE) as a combination death, myocardial infarction and target vessel revascularization. Kaplan–Meier analyses were performed for event-free survival between the three groups. Results: Between 05/2013 and 07/2019, 28 patients underwent DRS implantation of aorto-ostial coronary lesions. In comparison with 49 patients with DES implantation and 29 patients undergoing PCB treatment, no relevant differences in baseline parameters were identified. Median follow-up was 714 days, with an available follow-up of >1 year after intervention in 82.1% of patients. In the entire study cohort at two years after re-intervention, the TLR rate was 16% (17 patients), the MACE rate 37% (39 patients), and all-cause mortality 9% (10 patients), with no significant differences between the three groups. Conclusions: DRS implantation for treating stent recoil of aorto-ostial coronary lesions resulted in a high rate of TLR, and was associated with similar risk for death and MACE compared to treatment of in-stent-restenosis with DES or PCB. Randomized, larger comparisons of contemporary DES in patients exclusively presenting with stent recoil are necessary to further define the efficacy and safety of this approach.

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Section: Discussionmentioning

confidence: 99%