Related Experiment Video
Updated: May 29, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Everolimus-eluting stents for treatment of chronic total coronary occlusions
Jochen Wöhrle1, Wolfgang Rottbauer, Armin Imhof
1Department of Internal Medicine II, University of Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany. jochen.woehrle@uniklinik-ulm.de
Insights
Everolimus-eluting stents (EESs) show low restenosis and reintervention rates after coronary chronic total occlusion (CTO) recanalization. This study confirms EESs are safe and effective for CTO treatment, with no stent thrombosis observed.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomedical Engineering
Background:
- Coronary chronic total occlusions (CTOs) pose a high risk of restenosis and reintervention after recanalization.
- Everolimus-eluting stents (EESs) have demonstrated efficacy in non-occluded lesions.
- The antiproliferative effect of EESs in CTOs requires further investigation.
Purpose of the Study:
- To evaluate the efficacy of the Xience V everolimus-eluting stent (EES) in treating coronary chronic total occlusions (CTOs).
- To assess the antiproliferative impact of EESs in the context of CTO recanalization.
- To determine the rates of restenosis, reintervention, and stent thrombosis following EES implantation in CTOs.
Main Methods:
- Fifty-three patients with coronary CTOs (≥3 months occlusion, TIMI 0 flow) underwent EES implantation.
- Stents were implanted to cover the occluded and adjacent stenotic segments.
- Follow-up included angiography at 6 months and clinical assessment at 12 months, with late loss and composite clinical events as primary and secondary endpoints.
Main Results:
- Mean occlusion length was 24 mm, with a mean stent length of 79 mm.
- The primary endpoint, late loss at the occlusion site, was 0.22 mm.
- Binary restenosis occurred in 11% of patients, with target lesion reintervention in 6%; no deaths, myocardial infarctions, or stent thromboses were reported within 12 months.
Conclusions:
- Everolimus-eluting stents (EESs) demonstrate low angiographic late loss and restenosis rates in complex coronary chronic total occlusions (CTOs) after successful recanalization.
- EES implantation in CTOs is associated with a low rate of target lesion revascularization.
- No instances of stent thrombosis were observed within the 12-month follow-up period, indicating a favorable safety profile.
Background:
After successful recanalization of a coronary chronic total occlusion (CTO) the risk for restenosis and subsequent need for repeat intervention is high. Everolimus-eluting stents (EESs) were associated with low rates of restenosis, reintervention and stent thrombosis in non-occluded lesions. We sought to determine the antiproliferative impact of the everolimus-eluting Xience V stent in CTOs.
Methods:
Fifty-three patients with a CTO in a native coronary artery were included. CTO was defined as a duration of occlusion ≥3 months and thrombolysis in myocardial infarction 0 flow. EESs were exclusively implanted to completely cover the occluded and adjacent stenotic segments. Dual antiplatelet therapy was prescribed for 6 months. Follow-up angiography was scheduled at 6 months. Clinical follow-up was done at 12 months. The primary endpoint was late loss at the initial occlusion site. Secondary clinical endpoint was a composite of cardiac death, myocardial infarction not clearly attributable to a non-target vessel and target lesion revascularization.
Results:
Mean occlusion length was 24 ± 17 mm, ranging from 4 to 74 mm. Mean stent length was 79 ± 36 mm, ranging from 18 to 158 mm. Reference diameter was 3.27 ± 0.58 mm. Late loss at the initial occlusion site was 0.22 ± 0.69 mm. There were six (11%) binary restenosis with a target lesion reintervention in three (6%) patients. There was no death, myocardial infarction or stent thrombosis within 12 months.
Conclusion:
In patients with successful recanalization of complex CTOs the use of EESs results in a low angiographic late loss and restenosis rate without stent thrombosis throughout 12 months follow-up.
Related Concept Videos
01:18Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme (ECE). Of...
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
01:26Mitral Stenosis III: Medical Management
01:26Atherosclerosis III: Management