Which DES is the most appropriate for very small target vessels? Experimental study of stent expandable performance with SES, PES, ZES and EES

Horita, Yuki; Namura, Masanobu; Ikeda, Masatoshi; Tsuchiya, Taketoshi; Terai, Hidenobu; Fukuoka, Ryota; Takahashi, Naoto; Takagi, Toshimitsu

doi:10.1007/s12928-011-0053-4

Cited by 2 publications

(1 citation statement)

References 30 publications

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“… 43 , 44 Over time, great effort has been made to improve the technology, thus reducing strut thickness from 140 μm to approximately 70–80 μm, resulting in a dramatic reduction of thrombogenicity in bench studies. 17 , 45 Advances in polymer technology have been enormous; new biocompatible polymers (PBMA or PVDF-HFP) result in less inflammation after stent implantation, with the consequence of more complete and functional endothelization. 46 , 47 Also, CoCr-EES show fewer coating defects after implantation when compared to different DES, and this result was maintained over time and may improve vascular biocompatibility.…”

Section: Discussionmentioning

confidence: 99%

The everolimus-eluting Xience stent in small vessel disease: bench, clinical, and pathology view

Sánchez

Yahagi

Koppara

et al. 2014

MDER

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Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. The pathogenesis of CAD relates to the presence of atherosclerotic plaques in the coronary arteries, which are most frequently treated today by percutaneous coronary intervention. Small vessel disease treatment represents one-third of all percutaneous coronary interventions with higher rates of restenosis and major adverse cardiac events. Initially, drug-eluting stents (DES) were developed to reduce in-stent restenosis, improving clinical outcomes and reducing the need for target vessel revascularization. However, late and very late stent thrombosis emerged as a new problem compromising DES’s long-term results. The cobalt–chromium everolimus-eluting stent (CoCr-EES) represents the results of an evolutionary process in DES technology aimed at improving the shortcomings of first-generation DES. Small vessel CAD has historically been an obstacle to long-term patency following implantation of DES. Antirestenotic efficacy has been shown to be of high relevance in small vessels. Therefore, stent selection may play an important role in determining outcomes in this subgroup of patients. This article will review the performance of CoCr-EES in the treatment of small vessel CAD from preclinical, clinical, and pathology perspectives, and it will highlight the most important findings in this regard.

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Section: Discussionmentioning

confidence: 99%

The everolimus-eluting Xience stent in small vessel disease: bench, clinical, and pathology view

Sánchez

Yahagi

Koppara

et al. 2014

MDER

View full text Add to dashboard Cite

show abstract

Initial and late efficacy of everolimus-eluting stents for small and non-small coronary lesions from evaluating delayed late loss study

et al. 2017

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The aim of the present study was to evaluate the long-term outcomes at 2 years in patients in whom everolimus-eluting stents (EESs) were implanted in small and non-small vessels. A small vessel is an important risk factor for restenosis with BMSs, even in the first generation DESs. The 690 patients with 690 lesions implanted with an EES were enrolled and divided into two groups by vessel reference diameter (RD): >2.5 mm for non-small vessels (Non-S-group) and ≤2.5 mm for small vessels (S-group). Two years later, the 365 patients with no restenosis at 8 months who underwent angiography were enrolled into the late catch-up study. At the initial 8-month follow-up, the rates of restenosis and target lesion revascularization (TLR) of both groups were not significantly different (restenosis 3.9 vs 6.5%, p = 0.17; TLR 3.9 vs 6.5%, p = 0.17). At the late 2-year follow-up, there were no significant differences in the late loss (0.36 ± 0.66 vs 0.34 ± 0.50 mm, p = 0.14), net gain (1.50 ± 0.75 vs 1.26 ± 0.60 mm, p = 0.39), late catch-up restenosis rate (5.1 vs 3.4%, p = 0.38), TLR (4.9 vs 2.7%, p = 0.40), and delayed late loss (0.14 ± 0.58 vs 0.15 ± 0.49 mm, p = 0.10) between both groups. There is no correlation between delayed late loss and RD in all patients(r = -0.009) and in AMI patients (r = -0.004). These results demonstrate that the initial and late catch-up restenosis rates of small coronary vessels with EES placement were excellent, the same as for non-small coronary vessels. We suggest that involvement of small coronary arteries may not be a risk factor for restenosis and results of stenting for small coronary arteries with EES placement were excellent.

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Which DES is the most appropriate for very small target vessels? Experimental study of stent expandable performance with SES, PES, ZES and EES

Cited by 2 publications

References 30 publications

The everolimus-eluting Xience stent in small vessel disease: bench, clinical, and pathology view

The everolimus-eluting Xience stent in small vessel disease: bench, clinical, and pathology view

Initial and late efficacy of everolimus-eluting stents for small and non-small coronary lesions from evaluating delayed late loss study

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