One-year outcomes with the Firehawk sirolimus-eluting stent and biodegradable polymer guided by intravascular ultrasound

Abstract

To the Editor, Drug-eluting stents (DES) can show mechanical failure at implantation. Diagnosis of stent underexpansion through intravascular ultrasound (IVUS) seems to be the main mechanism of thrombosis and restenosis.1 In the past, durable first-generation DES polymers have been associated with late adverse clinical events. The Firehawk stent (MicroPort Medical, China), is a cobalt-chrome structure with biodegradable sirolimus-containing polymer coating in abluminal grooves, designed to mitigate polymer load and to reduce drug concentrations in the vessel wall.2 This third generation DES device has been tested in various studies.3 The TARGET All Comers trial reported noninferiority in target lesion failure (TLF) at 1 year of follow-up with the Firehawk stent compared with SFA XIENCE (Abbott, United States) with durable polymer. Although the results have shown noninferiority, a 1.2% rate of definitive thrombosis was observed throughout the 12-month follow-up, which could be related to the lack of use of intravascular imaging to guide stent implantation. The use of this imaging modality leads to reductions in mortality, treated vessel-related myocardial infarction (MI) and clinically guided revascularization compared with procedures guided by angiography alone. The aim of the present study was to assess the mid-term outcomes in real-world patients from a single center in Brazil who...