Crush stenting with paclitaxel-eluting or sirolimus-eluting stents for the treatment of coronary bifurcation lesions

• Published in: Angiology Vol. 59; no. 4; p. 475
• Main Authors: Chen, Shaoliang, Zhang, Junjie, Ye, Fei, Zhu, Zhongsheng, Lin, Song, Tian, Nailiang, Liu, Zhizhong, Fang, Weiyi, Chen, Yundai, Sun, Xuewen, Kwan, Tak W
• Format: Journal Article
• Language: English
• Published: United States 01.08.2008
• Subjects: Aged; Angioplasty, Balloon, Coronary - adverse effects; Angioplasty, Balloon, Coronary - instrumentation; Cardiovascular Agents - administration & dosage; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - etiology; Cardiovascular Diseases - mortality; Cardiovascular Diseases - prevention & control; Coronary Angiography; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - mortality; Coronary Artery Disease - therapy; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - etiology; Coronary Restenosis - mortality; Coronary Restenosis - prevention & control; Drug-Eluting Stents; Female; Humans; Male; Middle Aged; Paclitaxel - administration & dosage; Prospective Studies; Prosthesis Design; Sirolimus - administration & dosage; Time Factors; Treatment Outcome
• ISSN: 1940-1574
• DOI: 10.1177/0003319707312519

Two hundred forty-six patients with 252 bifurcation lesions were enrolled into a prospective, nonrandomized study to use paclitaxel-eluting or sirolimus-eluting stent for crush stenting in the treatment of coronary bifurcation lesions. Compared with the sirolimus-eluting stent group, the paclitaxel-eluting stent group had significantly higher mean late lumen and binary angiographic restenosis rates. Sirolimus-eluting stent versus paclitaxel-eluting stent recipients had significantly lower in-segment restenosis in the entire main vessel (15.7% vs 3.1%, P = .004), and simultaneous side branch and main vessel restenoses were solely detected in the paclitaxel-eluting stent group (11.9% vs 0%, P = .03). Target-lesion vessel revascularization and cumulative major adverse cardiac events rates were significantly higher in the paclitaxel-eluting versus the sirolimus-eluting stent group (17.99% vs 8.41%, P = .01; 19.4 vs 9.3%, P = .01; 23.6 vs 11.2%, P = .03). In this study with crush stenting, use of sirolimus-eluting stent, compared with paclitaxel-eluting stent, yielded significantly lower late lumen loss, restenosis, and revascularization rates, with comparable safety by 8-month follow-up.