Can intravascular ultrasound guidance modify the efficacy of drug-eluting stent over bare-metal stent in an aorto-ostial lesion?

Teruo Okabe, Akio Kawamura, Yuichiro Maekawa, Toshihisa Anzai, Shiro Iwanaga, Tsutomu Yoshikawa, Satoshi Ogawa

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Abstract

Purpose: We compared the efficacy of drug-eluting stents (DESs) versus bare-metal stents (BMSs) in de novo and native aorto-ostial lesions (AOLs) guided by intravascular ultrasound (IVUS). Method: Thirty-eight patients underwent DES implantation for 38 AOLs; 35 with sirolimus-eluting stents, and three with paclitaxel-eluting stents (DES group). The control group was composed of 40 AOLs treated by BMS. The incidence of the primary composite end point of all-cause mortality, Q-wave myocardial infarction and target vessel revascularization (TVR) as TVR-major adverse cardiac event (TVR-MACE) was evaluated during a 1-year follow-up. Clinical and IVUS parameters were compared between the DES and BMS groups, and Cox hazards model was used to calculate hazard ratios of several factors for the 1-year TVR-MACE. Results: Although the vessel, plaque, and stent volumes were significantly larger after the procedures in the DES group owing to longer lesions (18.3±5.1 vs. 13.2±5.9 mm, P<001), the stent volume index (10.8±2.6 vs. 12.4±3.3, P=024) was much smaller than that in the BMS group. During the 1-year follow-up, there were 13 TVR-MACEs in all patients (13% in DES vs. 20% in BMS, P=4 by Kaplan-Meier analysis). The Cox hazards model did not indicate any specific unfavorable factor for the 1-year TVR-MACE. Conclusions: The present study showed equality between DES and BMS on de novo and native AOLs about the 1-year TVR-MACE rate, even though a DES was used in longer and bulkier lesions as compared to BMS.

Original languageEnglish
Pages (from-to)105-110
Number of pages6
JournalCardiovascular Revascularization Medicine
Volume12
Issue number2
DOIs
Publication statusPublished - 2011 Mar 1

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Keywords

  • Aorto-ostial lesion
  • Bare-metal stent
  • Drug-eluting stent
  • Intravascular ultrasound

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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