Clinical and Angiographic Follow-Up of Small Vessel Lesions Treated With Paclitaxel-Eluting Stents (from the TRUE Registry)

Cosmo Godino, Shinichi Furuichi, Azeem Latib, Nuccia Morici, Alaide Chieffo, Enrico Romagnoli, Corrado Tamburino, Rossella Barbagallo, Michela Cera, David Antoniucci, Omer Goktekin, Carlo Di Mario, Bernard Reimers, Eberhard Grube, Flavio Airoldi, Giuseppe M. Sangiorgi, Antonio Colombo

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Several randomized trials have shown that sirolimus-eluting stents and paclitaxel-eluting stents (PES) are effective in reducing restenosis in respect to bare-metal stents, including the subset of small vessels. The objective of this study was to evaluate "real world" angiographic and clinical outcomes of a large series of patients enrolled in the TRUE registry and treated with PES for both small vessel and very small vessel lesions. A consecutive series of 675 patients (926 lesions) with reference vessel diameter <2.75 mm measured by quantitative coronary angiography analysis were analyzed. The primary end point was the rate of angiographic in-stent restenosis and 1-year major adverse cardiac events. In this study 390 lesions were identified as small vessel (reference vessel diameter ≥2.25 and <2.75 mm) and 536 lesions as very small vessel (reference vessel diameter <2.25 mm). Overall in-stent restenosis was 15.5% (n = 96). Compared with small vessel, the very small vessel lesions had more in-stent restenosis (21.7% vs 11.4%, p <0.001) and in-segment restenosis (29.3% vs 22.5%, p = 0.055). The majority of the restenotic lesions (n = 125) were focal (57%, n = 71). At 1 year, cardiac death was 1.6% (n = 11), acute myocardial infarction 0.5% (n = 4.), and the target lesion revascularization 12.8% (n = 86). Cumulative major adverse cardiac events rate was 17.3% (n = 119). The rate of definite and probable stent thrombosis was 0.9% (n = 8). In conclusion, in comparison with historical bare-metal stent controls, this large series of small vessel lesions treated with PES confirms previous results reporting the efficacy of PES in small vessels. The rate of subacute and late stent thrombosis was low in this subgroup of patients.

Original languageEnglish (US)
Pages (from-to)1002-1008
Number of pages7
JournalAmerican Journal of Cardiology
Volume102
Issue number8
DOIs
StatePublished - Oct 15 2008
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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