Comparison Among Ultra-Thin Coronary Stents: A Network Meta-Analysis

Area of Science:

• Cardiology
• Medical Devices
• Interventional Cardiology

Background:

• Ultrathin-strut drug-eluting stents (DES) may offer improved outcomes compared to thicker-strut DES.
• Limited comparative data exists among different ultrathin DES devices.

Purpose of the Study:

• To compare the efficacy and safety of various ultrathin DES against each other and against thicker-strut DES.
• To evaluate target lesion failure (TLF) and other key clinical outcomes at 1-year follow-up.

Main Methods:

• Network meta-analysis of randomized controlled trials comparing ultrathin (<70 µm struts) and thicker-strut DES in an all-comers population.
• Primary endpoint: Target Lesion Failure (TLF) at 1-year.
• Secondary endpoints: Overall mortality, myocardial infarction, target lesion revascularization (TLR), and stent thrombosis.

Main Results:

• Nine studies with 20,081 patients were included; 9,509 received ultrathin DES (Orsiro, MiStent, Supraflex).
• No significant differences in TLF were observed among ultrathin DES at 1-year.
• Orsiro showed a similar TLF risk to Supraflex and the highest probability for best performance in TLF, myocardial infarction, and TLR.

Conclusions:

• Ultrathin DES demonstrate comparable TLF risk to thicker-strut DES.
• Orsiro exhibited the highest likelihood of superior performance regarding TLF and TLR compared to other ultrathin DES and thicker-strut devices.