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Long-term outcomes after percutaneous revascularization of complex coronary bifurcation lesions using a dedicated
Andreas S Triantafyllis1, Johan Bennett, Efstathios Pagourelias
1Department of Cardiovascular Medicine, University Hospitals Leuven, Belgium, 3000 Leuven, Belgium. andtridoc@yahoo.gr.
Insights
The AXXESS stent safely treats complex bifurcation lesions, showing excellent long-term outcomes. Left main lesions had higher major adverse cardiac events rates compared to non-left main lesions.
Area of Science:
- Interventional Cardiology
- Biomaterials Science
Background:
- Complex bifurcation lesions pose treatment challenges.
- Biolimus A9-eluting stents offer a therapeutic option for these lesions.
Purpose of the Study:
- To assess the long-term clinical efficacy and safety of the AXXESS self-expanding biolimus A9-eluting stent.
- Evaluate outcomes in patients with complex bifurcation lesions.
Main Methods:
- A single-center study included 123 patients treated with the AXXESS stent.
- Median follow-up was 5 years.
- Primary endpoint: Major Adverse Cardiac Events (MACE); Secondary endpoints: MACE components, stent thrombosis, death, revascularization.
Main Results:
- Low MACE rate (8.9%) with no definite/probable stent thrombosis observed.
- Cardiac death (1.6%), non-periprocedural MI (1.6%), and elective target lesion revascularization (5.7%) were reported.
- Left main bifurcation lesions showed a higher MACE rate (25%) versus non-LM lesions (6.5%, p=0.04).
Conclusions:
- Percutaneous treatment of complex bifurcation lesions with the AXXESS stent is safe.
- The stent demonstrates excellent long-term clinical outcomes.
- Outcomes are particularly favorable in non-left main bifurcation lesions.
Background:
To evaluate long-term clinical outcomes after treatment of complex bifurcation lesions with the AXXESS dedicated self-expanding biolimus A9-eluting bifurcation stent.
Methods:
Between 2004 and 2013, 123 patients with complex bifurcation lesions were treated in a single-center with the AXXESS stent in the proximal main vessel (MV) and additional drug-eluting stents in branches when required. Median follow-up was 5 years. Primary endpoint was the rate of major adverse cardiac events (MACE). Secondary endpoints included MACE components (cardiac death, non-periprocedural clinical myocardial infarction [MI], target lesion revascularization [TLR] and definite/probable stent thrombosis [ST]) as well as all-cause death, target vessel revascularization (TVR) and non-TVR.
Results:
During follow-up, 11 (8.9%) patients experienced a MACE, of whom 2 (1.6%) suffered cardiac death, 2 (1.6%) had a non-periprocedural clinical MI requiring TLR, and 7 (5.7%) underwent elective TLR. No definite/probable ST was observed. All-cause death occurred in 9 (7.3%) patients, TVR in 11 (8.9%) and non-TVR in 11 (8.9%). Patients treated for left main (LM) bifurcation lesions were more likely to experience MACE than non-LM bifurcation lesions (25% vs. 6.5%, p = 0.04).
Conclusions:
Percutaneous revascularization of complex bifurcation lesions with the AXXESS stent is safe and provides excellent long-term results, especially in non-LM lesions.
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