EFFICACY OF SIROLIMUS ELUTING STENTS IMPLANTATION IN DIFFUSE (LONG AND EXTREMELY LONG) CORONARY ATHEROSCLEROTIC LESIONS

Abstract

Aim. Comparison of efficacy of stents coated with sirolimus (group I — 116 patients), and bare metallic stents (group II — 117 patients) in treatment of diffuse (long) atherosclerotic lesions in coronary arteries.Material and methods. The groups were comparable by main parameters. Diabetes was found in 19% and 13,7%, respectively; multivessel lesion in 87,1% and 80,4%; vessel caliber less than 2,75 mm — 46,5% and 23,9%, respectively. Length of the lesion was 25,9±6,6 mm (28-93 mm) in group I and 22,1±7,8 mm (26-102 mm) in group II. Totally, 473 stents implanted into 232 arteries (2,1 per artery): group I — 184 stents in 116 arteries (overlap of 2> stents in 87,9% cases) and 289 in 117 in group II (superposition of stents in 87,1%).Results. The direct success at short term was noted in 113 patients in group I (97,4%) and in 116 in group II (99,1%) (p=0,74). In both groups there were no cases of acute thrombosis of stents. Subacute thrombosis (in 1-3 weeks) was noted in 2 patients (1,7%) in group I and in 1 (0,85%) in group II (p=0,47). Long term angiographic restenosis was noted in 12 patients from group I (10,6%) and in 66 in group II (56,9%) (p<0,0025). Also, in group II 47 patients from 66 had diffuse restenosis (71,2%), as in group I there was no diffuse restenosis. Survival rate with no MACE or angina in 12 months was 79,8% in group I, and 31% in group II.

Keywords

• diffuse atherosclerosis
• long lesions of coronary arteries
• drug eluting stents
• sirolimus