Rنber، نويسنده , , Lorenz and Jüni، نويسنده , , Peter and Lِffel، نويسنده , , Lukas and Wandel، نويسنده , , Simon and Cook، نويسنده , , Stéphane and Wenaweser، نويسنده , , Peter and Togni، نويسنده , , Mario and Vogel، نويسنده , , Rolf and Seiler، نويسنده , , Christian and Eberli، نويسنده , , Franz and Lüscher، نويسنده , , Thomas and Meier، نويسنده , , Bernhard and Windecker، نويسنده , , Stephan، نويسنده ,
pared the angiographic and long-term clinical outcomes of patients with and without overlap of drug-eluting stents (DES).
erlap has been associated with delayed healing and increased inflammation in experimental studies, but its impact on clinical outcome is not well established.
lyzed the angiographic and clinical outcomes of 1,012 patients treated with DES in the SIRTAX (Sirolimus-Eluting Versus Paclitaxel-Eluting Stents for Coronary Revascularization) trial according to the presence or absence of stent overlap and the number of stents per vessel: 134 (13.2%) patients with multiple DES in a vessel with overlap, 199 (19.7%) patients with multiple DES in a vessel without overlap, and 679 (67.1%) patients with 1 DES per vessel.
raphic follow-up at 8 months showed an increased late loss in DES overlap patients (0.33 ± 0.61 mm) compared with the other groups (0.18 ± 0.43 mm and 0.15 ± 0.38 mm, p < 0.01). The smallest minimal lumen diameter was located at the zone of stent overlap in 17 (68%) of 25 patients with stent overlap who underwent target lesion revascularization. Major adverse cardiac events were more common in patients with DES overlap (34 events, 25.4%) than in the other groups (42 events, 21.1% and 95 events, 14.0%) at 3 years (p < 0.01). Both the risk of target lesion revascularization (20.2% vs. 16.1% vs. 9.7%, p < 0.01) and the composite of death or myocardial infarction (17.2% vs. 14.1% vs. 9.1%, p = 0.01) were increased in patients with DES overlap compared with the other groups.
erlap occurs in >10% of patients undergoing percutaneous coronary intervention in routine clinical practice and is associated with impaired angiographic and long-term clinical outcome, including death or myocardial infarction. (Sirolimus-Eluting Versus Paclitaxel-Eluting Stents for Coronary Revascularization; NCT00297661).
Coronary Artery Disease , Drugs , Overlap , restenosis , stents