Unprotected left main coronary artery stenting with zotarolimus (Endeavor) drug-eluting stents: a single center retrospective experience.

Abstract

OBJECTIVES:

To report the safety and efficacy of zotarolimus eluting stents for treatment of unprotected left main coronary artery disease.

BACKGROUND:

Percutaneous stent insertion is an increasingly popular alternative to bypass surgery for the management of left main (LM) coronary artery disease. While data support the use of sirolimus- and paclitaxel-coated stents in the LM coronary artery, there are no published series reporting results with Endeavor (zotarolimus) stents, particularly in the context of unprotected left main (ULM) lesions.

METHODS:

We retrospectively identified 40 consecutive patients who had ULM disease treated with Endeavor stents (ZES) and who had follow-up angiography. The primary endpoint was the prevalence of major adverse cardiac events (MACE), including cardiac/unexplained death, nonfatal myocardial infarction (MI), and in-stent restenosis (ISR)/target lesion revascularization (TLR).

RESULTS:

Angiographic and procedural success was achieved in all cases. Follow-up angiography occurred on average 5.6 ± 0.9 months after the index procedure. There were three incidences of ISR requiring TLR and another patient who had a NSTEMI in the follow-up period. At late follow-up (12.4 ± 1.8 months) three patients underwent CABG (one for RCA stenosis) and four patients died without knowledge of the status of the ULM stent (two cardiovascular and two deaths related to cancer progression).

CONCLUSIONS:

In conclusion, our experience with Endeavor stents for the treatment of ULM disease demonstrates excellent angiographic and clinical outcomes, with a 7.5% ISR/TLR rate and a 15% MACE rate, respectively, at an average clinical follow-up of 12.4 months.

• Authors: Trevor Simard, Benjamin Hibbert, Aun-Yeong Chong, Peter Ruchin, Michel Le May, Marino Labinaz, Michael Froeschl, Derek So, Christopher Glover, Jean-Francois Marquis, Edward O'Brien
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 80 Issue 2 Pg. E15-22 (Aug 01 2012) ISSN: 1522-726X [Electronic] United States
• PMID: 21805580 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 Wiley Periodicals, Inc.

Chemical References

• Cardiovascular Agents
• zotarolimus
• Sirolimus

Topics

• Aged
• Angioplasty, Balloon, Coronary (adverse effects, instrumentation, mortality)
• Cardiovascular Agents (administration & dosage)
• Cause of Death
• Coronary Angiography
• Coronary Artery Disease (diagnosis, mortality, therapy)
• Coronary Restenosis (etiology, mortality)
• Drug-Eluting Stents
• Female
• Humans
• Male
• Middle Aged
• Myocardial Infarction (etiology, mortality)
• Ontario
• Prosthesis Design
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Sirolimus (administration & dosage, analogs & derivatives)
• Time Factors
• Treatment Outcome
• Ultrasonography, Interventional