Related Experiment Videos
[Outcome of patients implanted with bioabsorbable polymer sirolimus-eluting stent (Excel) and the durable polymer
Zhan GAO1, Yue-jin YANG, Ji-lin CHEN
1Coronary Heart Disease Division, Cardiovascular Institute and Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China. gaowangjia@163.com
Insights
The Excel bioabsorbable polymer sirolimus-eluting stent and the Cypher durable polymer sirolimus-eluting stent showed comparable one-year clinical and seven-month angiographic outcomes in patients with coronary artery disease.
Area of Science:
- Interventional Cardiology
- Biomaterials Science
Background:
- Coronary artery disease (CAD) management often involves percutaneous coronary intervention (PCI) with stenting.
- Sirolimus-eluting stents (SES) are widely used, with variations in polymer coatings affecting long-term outcomes.
- Bioabsorbable polymer SES aim to reduce risks associated with durable polymers.
Purpose of the Study:
- To compare the clinical and angiographic outcomes of patients with CAD treated with the Excel bioabsorbable polymer SES versus the Cypher durable polymer SES.
Main Methods:
- A retrospective analysis of 591 consecutive patients undergoing PCI with either Excel (n=350) or Cypher (n=241) stents.
- One-year clinical follow-up and seven-month angiographic follow-up data were analyzed.
- Major adverse cardiac events (MACE), stent thrombosis, and restenosis rates were assessed.
Main Results:
- Baseline characteristics differed, with more complex disease in the Excel group.
- One-year MACE rates were similar (8.3% vs. 7.1%, P=0.641), as were cardiac death, myocardial infarction, and target vessel revascularization rates.
- Stent thrombosis rates were low and comparable between groups.
- Seven-month angiographic follow-up showed similar restenosis rates but significantly lower in-stent and in-segment late lumen loss for the Excel stent.
Conclusions:
- The Excel bioabsorbable polymer SES demonstrates comparable one-year clinical and seven-month angiographic outcomes to the Cypher durable polymer SES in patients with CAD.
- The findings suggest that bioabsorbable polymer technology provides a safe and effective alternative to durable polymers for sirolimus-eluting stents.
Objective:
To compare the outcome of patients with coronary artery disease implanted with bioabsorbable polymer sirolimus-eluting stent (Excel) and the durable polymer sirolimus-eluting stent (Cypher).
Methods:
One year clinical and 7 months angiographic follow-up data were analyzed in 591 consecutive patients implanted with Excel (E group: n = 350, 58.1 +/- 10.9 years old) or Cypher (C group: n = 241, 56.4 +/- 10.7 years old) during May 2006 to November 2006 in our center.
Results:
There were more patients with old myocardial infarction and triple vessel diseases while there were less left main stem disease in E group compared to those of C group at baseline. Reference vessel diameter [(2.76 +/- 0.45) mm vs. (2.87 +/- 0.38) mm, P = 0.043], stent diameter [(3.11 +/- 0.48) mm vs. (3.25 +/- 0.34) mm, P = 0.045] and minimal stent diameter [(2.67 +/- 0.43) mm vs. (2.78 +/- 0.35) mm, P = 0.046] and rate of post-dilation (15.9% vs. 46.7%, P < 0.001) were all significantly smaller in E group compared to those in C group. Procedure was successful in all patients. One year clinical follow-up results showed similar results on major adverse cardiac events (MACE) rate (8.3% vs. 7.1%, P = 0.641), rate of cardiac death (0.9% vs.0.0%, P = 0.274), non-fatal myocardial infarction (2.0% vs. 1.2%, P = 0.747) and target vessel revascularization (5.4% vs. 5.8%, P = 0.857) between E and C groups. Total (0.9% vs. 0.4%, P = 0.649), early (0.6% vs. 0.0%, P = 0.516) and late (0.3% vs. 0.4%, P = 1.000) stent thrombosis rates according to Academic Research Consortium (ARC) standard definitions (definite + probable) were also similar between the E and C groups. Seven months angiographic follow-up results indicated that there were no differences of in-stent and in-segment restenosis rate between E and C groups (4.7% vs. 3.2%, P = 0.725; 5.6% vs. 3.2%, P = 0.505) but in-stent and in-segment late loss were significantly smaller in E group than those in C group [(0.18 +/- 0.07) mm vs. (0.21 +/- 0.08) mm, P < 0.001; (0.21 +/- 0.09) mm vs. (0.23 +/- 0.11) mm, P = 0.003].
Conclusion:
One year clinical and 7 months angiographic outcome were comparable in patients implanted with Excel and Cypher sirolimus-eluting stents.