Sirolimus-eluting stents in the treatment of chronic total coronary occlusions: results from the prospective multi-center German Cypher Stent Registry.

Abstract

OBJECTIVES:

We assessed the effectiveness and safety of the sirolimus-eluting stent (SES) in the treatment of chronic total coronary occlusions.

BACKGROUND:

Chronic total occlusions (CTO) of coronary vessels have an unacceptable high restenosis rate of approximately 50% after stenting. Few data exist about the performance of drug eluting stents (DES) in the treatment of CTO.

METHODS:

All coronary interventions using the Cypher stent performed at 122 centers engaged in the German Cypher registry between April 2002 and December 2004 were analyzed; a total of 5,344 patients; 374 with and 4,970 without CTO were compared.

RESULTS:

There was no significant difference between both groups regarding demographics, coronary status and left ventricular function. Patients in the CTO group had a higher level of angina symptoms, the coronary lesions were more complex and the stents used were smaller and longer than in the No-CTO group. The In-hospital outcome was similar in both groups, with importantly no difference regarding mortality and complications. Stenting was as successful in the CTO as in the No-CTO group; during a follow-up of 6.6 months we found no significant difference regarding the rate of mortality, complications, and revascularization between both groups.

CONCLUSIONS:

Implantation of the Cypher stent reduces the restenosis rate and seems to be a safe and effective tool for the treatment of chronic total coronary occlusions.

• Authors: Christian Zellerhoff, Steffen Schneider, Jochen Senges, Thomas Pfannebecker, Christian Hamm, Ulrich Tebbe
• Journal: Clinical research in cardiology : official journal of the German Cardiac Society (Clin Res Cardiol) Vol. 97 Issue 4 Pg. 253-9 (Apr 2008) ISSN: 1861-0684 [Print] Germany
• PMID: 18046523 (Publication Type: Controlled Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Immunosuppressive Agents
• Sirolimus

Topics

• Aged
• Angioplasty, Balloon, Coronary (instrumentation, mortality)
• Blood Vessel Prosthesis
• Chronic Disease
• Coronary Occlusion (therapy)
• Coronary Restenosis (epidemiology)
• Drug Delivery Systems
• Drug-Eluting Stents
• Female
• Germany
• Humans
• Immunosuppressive Agents (administration & dosage)
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Prospective Studies
• Registries (statistics & numerical data)
• Sirolimus (administration & dosage)
• Treatment Outcome