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Novel ultra-long (48 mm) everolimus-eluting stent for diffusely coronary vessels disease

Lorenzo Genuardi1, Francesco Burzotta2, Giulio Russo1

  • 1Institute of Cardiology, A. Gemelli IRCCS University Policlinic Foundation, Sacred Heart Catholic University, Rome, Italy.

Minerva Cardioangiologica
|March 22, 2019
PubMed

Insights

Ultra-long drug-eluting stents show promising results in treating diffuse coronary artery disease, reducing the need for stent overlaps during percutaneous coronary intervention (PCI). This real-world study found a 7% device-oriented composite endpoint rate in patients treated with 48 mm everolimus-eluting stents.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Diffuse coronary artery disease often requires overlapping stents, increasing risks.
  • Novel ultra-long drug-eluting stents (DES) aim to minimize stent overlap.
  • Everolimus-eluting stents (EES) are a type of DES used in percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To evaluate the clinical outcomes of PCI using a novel 48 mm EES in a real-world population.
  • To assess the effectiveness of ultra-long EES in reducing stent overlaps for diffuse coronary disease.
  • To identify factors influencing device-oriented composite endpoint (DOCE) after PCI with ultra-long EES.

Main Methods:

  • A real-world cohort of 216 patients undergoing PCI with 48 mm EES was analyzed.
  • Patients were treated between June 2015 and April 2017, excluding those in cardiogenic shock.
  • Vessels were categorized as "very long lesion" or "multiple focal disease"; DOCE was the primary endpoint.

Main Results:

  • 230 vessels in 216 patients were treated; 43.9% required overlapping stents.
  • The median follow-up was 474 days, with a 7% DOCE rate and no stent thrombosis.
  • Diabetes was associated with increased DOCE, while "multiple focal disease" predicted lower DOCE.

Conclusions:

  • The use of ultra-long EES in real-world practice shows promising results for diffuse coronary disease.
  • These stents may effectively limit the need for stent overlaps during PCI.
  • Further research can explore long-term outcomes and specific patient subgroups.
Abstract

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