Update on the everolimus-eluting coronary stent system: results and implications from the SPIRIT clinical trial program

Abstract

Drug-eluting stents (DES) have had a major impact in interventional cardiology. Compared to bare metal stents, they significantly reduce restenosis and the need for target vessel revascularization. Four DES are available in the US, the first-generation sirolimuseluting (Cypher ®) and paclitaxel-eluting (Taxus ®) stents and later approved second-generation everolimus-eluting (Xience V ®) and zotarolimus-eluting (Endeavor ®) stents. The Xience V stent was approved on the basis of clinical efficacy and safety data from 3 studies in the SPIRIT clinical trial program. Within this trial series, the Xience V was superior to its bare metal stent counterpart, the Vision ® stent, and noninferior to the paclitaxel-eluting stent for target vessel failure at 9 months. This review provides a comprehensive assessment of the data derived from both the pre-and post-approval randomized controlled trials and registry studies of Xience V that comprise the SPIRIT clinical trial program including recently published mid-term outcomes. The implications of the results in terms of interventional practice will be discussed.

Stent Fracture after Everolimus-Eluting Stent Implantation

“…The risk of SF in EES has never been assessed, perhaps due to the relatively new introduction of this stent. EES uses cobalt chromium technology and confers a very unique architecture with the thinnest strut profile [ 10 ]. It remains unknown if this design and the cobalt chromium composition might modify the risk of SF compared to the stainless steel DES generation (SES and PES).…”

“…The everolimus eluting stent (EES; Multilink Vision platform, Abbott Vascular, Temecula, CA), is a new DES with promising long-term results [ 7 – 9 ]. As compared with other DES, EES provides the thinnest available strut profile (0.08 mm) [ 10 ]. The incidence of SF with EES has never been assessed.…”

Novel drug-eluting stents in the treatment of de novo coronary lesions

“… 4 – 6 While other first-generation DES have been produced, 7 the second-generation DES now include the zotarolimus- (Endeavor; Medtronic, Minneapolis, MN) and the everolimus- (Xience V; Abbott Vascular, Redwood City, CA) eluting stents. 8 , 9 …”