Selective versus Exclusive Use of Drug-Eluting Stents in Treating Multivessel Coronary Artery Disease: A Real-World Cohort Study

Abstract

There have been attempts to find new approaches to the treatment of multivessel coro nary artery disease without increasing adverse events. Deployment of drugeluting stents (DES) for complex lesions and baremetal stents (BMST he drug-eluting stent (DES), in comparison with the bare-metal stent (BMS), has been associated with a reduction both in the incidence of restenosis and in the need for repeat interventions.1-4 However, the benefit of the DES appears to be confined to lowering the risks of repeat interventions, because mortality rates and the risk of myocardial infarction (MI) have not been lessened by the DES. 5,6 Other issues that should be considered in patients with DES implants are late thrombosis in a small but significant number of patients 7-9 and the need for prolonged dual antiplatelet therapy.In multivessel percutaneous coronary intervention (PCI), there have been attempts to find new approaches to revascularization in an effort to minimize cost, late thrombosis, and the risk of early discontinuation of dual antiplatelet therapy. These considerations have led to the development of a practice in which DES is used for complex, high-risk lesions and BMS for simple and low-risk lesions, even in the same patient. 10Although this approach already has been applied in the real world, its outcome has yet to be fully evaluated.The aim of this study was to investigate the clinical impact of the DES when used in combination with the BMS in the percutaneous treatment of multivessel coronary artery disease (CAD). We compared the results of 3 different approaches in the

Hybrid Coronary Percutaneous Treatment with Metallic Stents and Everolimus-Eluting Bioresorbable Vascular Scaffolds: 2-Years Results from the GABI-R Registry

“…Reports on the short-term outcomes of this so-called hybrid stenting strategy (the use of both metallic stents and BVS in the same patient or lesion) have been previously published [32,33,34,35]. Collectively, these studies reported that the use of a hybrid approach might be an acceptable compromise to overcome the limitations of BVS.…”

Biodegradable-Polymer Biolimus-Eluting Stents versus Durable-Polymer Everolimus-Eluting Stents at One-Year Follow-Up: A Registry-Based Cohort Study

“…Implantation of the drug-eluting stents (DESs), in comparison with the bare-metal stents (BMS), has conferred better outcomes for coronary artery stenting. [1][2][3][4] Although the administration of the first-generation DES showed a higher rate of success than that of the BMS, doubts were raised over its safety because of the reported cases of late stent thrombosis and very late restenosis. 5 The link between late stent thrombosis and incomplete endothelial coverage of the stent struts caused changes in the design and materials of the platforms and polymers of the stents.…”