Outcomes of SES in CTO
Coronary occlusion, drug-eluting stent, percutaneous coronary intervention, sirolimus, target lesion failure
Objectives: We aimed to evaluate the clinical outcomes in patients with chronic total occlusion treated with Indolimus, biodegradable polymer coated sirolimus-eluting stent, in real clinical practice.
Methods: We evaluated clinical outcomes in 170 patients, who underwent successful recanalization of chronic total occlusion with Indolimus between April-2012 and June-2014. During 9-month, primary endpoint was target lesion failure (TLF), a miscellany of cardiac death, myocardial infarction (MI), target lesion revascularization(TLR) and target vessel revascularisation. We considered stent thrombosis as a clinical outcome parameter.
Results: The mean age was 50.7 years and 142(83.5%) patients were predominantly male. The average stent length and diameter were 30.8 ±8.4 mm and 3.1 ±0.4 mm, respectively. The cumulative TLF at 9-month was 2.9% which included one, one and three cases of cardiac death, TLR and MI, respectively.
Conclusion: In real clinical practice, treatment of chronic total occlusionwith Indolimus sirolimus-eluting stent showed favourable clinical outcomes with high success rates.
Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. 2013 ESC guidelines on the management of stable coronary artery disease. The Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Revista Española de Cardiología. 2014;67(02):135-.
Aziz S, Ramsdale D. Chronic total occlusions-a stiff challenge requiring a major breakthrough: is there light at the end of the tunnel? Heart. 2005; 91(suppl 3): iii42-iii8.
Kahn JK. Angiographic suitability for catheter revascularization of total coronary occlusions in patients from a community hospital setting. American Heart Journal. 1993;126(3):561-4.
Ruygrok P, De Jaegere P, Verploegh J, Van Domburg R, De Feyter P. Immediate outcome following coronary angioplasty A contemporary single centre audit. European Heart Journal. 1995; 16(suppl L): 24-9.
Brilakis ES, Grantham JA, Rinfret S, Wyman RM, Burke MN, Karmpaliotis D, et al. A percutaneous treatment algorithm for crossing coronary chronic total occlusions. JACC: Cardiovascular Interventions. 2012;5(4):367-79.
Shah PB. Management of coronary chronic total occlusion. Circulation. 2011;123(16):1780-4.
Puma JA, Sketch MH, Tcheng JE, Harrington RA, Phillips HR, Stack RS, et al. Percutaneous revascularization of chronic coronary occlusions: an overview. Journal of the American College of Cardiology. 1995;26(1):1-11.
Rambaldi R, Hamburger JN, Geleijnse ML, Poldermans D, Kimman GJ, Aiazian AA, et al. Early recovery of wall motion abnormalities after recanalization of chronic totally occluded coronary arteries: a dobutamine echocardiographic, prospective, single-center experience. American Heart Journal. 1998;136(5):831-6.
Ivanhoe R, Weintraub W, Douglas J, Lembo N, Furman M, Gershony G, et al. Percutaneous transluminal coronary angioplasty of chronic total occlusions. Primary success, restenosis, and long-term clinical follow-up. Circulation. 1992;85(1):106-15.
Stone GW, Rutherford BD, McConahay DR, Johnson WL, Giorgi LV, Ligon RW, et al. Procedural outcome of angioplasty for total coronary artery occlussion: An analysis of 971 lesions in 905 patients. Journal of the American College of Cardiology. 1990;15(4):849-56.
Morice M-C, Serruys PW, Sousa JE, Fajadet J, Ban Hayashi E, Perin M, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. New England Journal of Medicine. 2002;346(23):1773-80.
Degertekin M, Serruys PW, Foley DP, Tanabe K, Regar E, Vos J, et al. Persistent inhibition of neointimal hyperplasia after sirolimus-eluting stent implantation long-term (Up to 2 years) clinical, angiographic, and Intravascular ultrasound follow-up. Circulation. 2002;106(13):1610-3.
Hoye A, Ong A, Aoki J, Van Mieghem C, Rodriguez Granillo GA, Valgimigli M, et al. Drug-eluting stent implantation for chronic total occlusions: comparison between the sirolimus-and paclitaxel-eluting stent. Euro Intervention. 2005;1(2):193-7.
Nakamura S, Bae J-H. Recent progress of the use of interventional therapy for chronic total occlusion. Korean Circulation Journal. 2008;38(6):295-300.
Cutlip DE, Windecker S, Mehran R, Boam A, Cohen DJ, van Es G-A, et al. Clinical end points in coronary stent trials a case for standardized definitions. Circulation. 2007;115(17): 2344-51.
Grouve E, Kristensen S. Stent thrombosis: definitions, mechanisms and prevention. E-Journal of Cardiology Practice. 2007;32(5).
Mehran R, Claessen BE, Godino C, Dangas GD, Obunai K, Kanwal S, et al. Long-term outcome of percutaneous coronary intervention for chronic total occlusions. JACC: Cardiovascular Interventions. 2011;4(9):952-61.
Grantham JA, Marso SP, Spertus J, House J, Holmes DR, Rutherford BD. Chronic total occlusion angioplasty in the United States. JACC: Cardiovascular Interventions. 2009; 2(6): 479-86.
Joyal D, Afilalo J, Rinfret S. Effectiveness of recanalization of chronic total occlusions: a systematic review and meta-analysis. American Heart Journal. 2010;160(1):179-87.
Noguchi T, Miyazaki M, Morii I, Daikoku S, Goto Y, Nonogi H. Percutaneous transluminal coronary angioplasty of chronic total occlusions. determinants of primary success and long‐term clinical outcome. Catheterization and cardiovascular interventions. 2000;49(3): 258-64.
Hoye A. The how and why of… Chronic Total Occlusions. Part Two: Why we treat CTOs the way we do. Euro Intervention: Journal of Euro PCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2006;2(3):382.
Fefer P, Knudtson ML, Cheema AN, Galbraith PD, Osherov AB, Yalonetsky S, et al. Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. J Am Coll Cardiol. 2012; 59(11):991-7. Epub 2012/03/10.
Hoye A, Tanabe K, Lemos PA, Aoki J, Saia F, Arampatzis C, et al. Significant reduction in restenosis after the use of sirolimus-eluting stents in the treatment of chronic total occlusions. Journal of the American College of Cardiology. 2004; 43(11): 1954-8.
Suttorp MJ, Laarman GJ, Rahel BM, Kelder JC, Bosschaert MA, Kiemeneij F, et al. Primary Stenting of Totally Occluded Native Coronary Arteries II (PRISON II): a randomized comparison of bare metal stent implantation with sirolimus-eluting stent implantation for the treatment of total coronary occlusions. Circulation. 2006;114(9):921-8. Epub 2006/08/16.
Nakamura S, Muthusamy TS, Bae J-H, Cahyadi YH, Udayachalerm W, Tresukosol D. Impact of sirolimus-eluting stent on the outcome of patients with chronic total occlusions. The American Journal of Cardiology. 2005;95(2):161-6.
Ge L, Iakovou I, Cosgrave J, Chieffo A, Montorfano M, Michev I, et al. Immediate and mid-term outcomes of sirolimus-eluting stent implantation for chronic total occlusions. European Heart Journal. 2005; 26(11): 1056-62.
Rajasekhar D, Vanajakshamma V, Shashank C, Srinivasakumar M, Sivasankara C. The real world experience of the biodegradable polymercoated sirolimuseluting coronary stent system. Catheterization and Cardiovascular Interventions. 2014.
Rajasekhar D, Vanajakshamma V, Babu S, Sivasankara C, Thakkar A. Clinical Outcomes from Unselected Real-World Patients with Acute Myocardial Infarction Receiving Biodegradable Polymer Coated Sirolimus-Eluting Stents. Journal of Cardiology and Therapeutics. 2013;1(2):64-70.
Rajasekhar D, Vanajakshamma V, Babu S, Sivasankara C, Khambhati BM, Thakkar AS. Safety and Efficacy of Sirolimus-Eluting Stent in Diabetic Patients Compared with Non-Diabetic Patients Undergoing Percutaneous Coronary Intervention. Journal of Cardiology and Therapeutics. 2014; 2(1): 21-6.
Polavarapu A, Polavarapu RS, Prajapati J, Raheem A, Thakkar K, Kothari S, et al. Favorable Outcomes after Implantation of Biodegradable Polymer Coated Sirolimus-Eluting Stents in Diabetic Population: Results from INDOLIMUS-G Diabetic Registry. International Journal of Vascular Medicine. 2015; 2015.
Sarma R, Prajapati J, Raheem A, Thakkar K, Kothari S, Thakkar A. Nine-Months Clinical Outcome of Biodegradable Polymer Coated Sirolimus-eluting Stent System: A Multi-Centre “Real-World” Experience. Journal of clinical and diagnostic research: JCDR. 2015;9(8):OC23.
Polavarapu A, Sarma R, Prajapati J, Thakkar K, Raheem A, Mayall T, et al. Clinical outcomes from unselected “real-world” patients with long coronary lesion receiving 40mm biodegradable polymer coated sirolimus-eluting stent. Scientifica. 2015;2015.
Lotan C, Almogar Y, Kuiper K, Suttorp MJ, Wijns W. Sirolimus‐Eluting Stent in Chronic Total Occlusion: The SICTO Study. Journal of interventional cardiology. 2006;19(4):307-12.
Nakamura S, Ogawa H, Yeo H, Udayachalerm W, Tresukosol D, Tansuphaswadikul S. Drug-Eluting Stents for the Treatment of Chronic Total Occlusion: A Comparison with Sirolimus, Paclitaxel, Zotarolimus (Endeavor Resolute), BiolimusA9, EPC Capture and Everolimus-Eluting Stent: Multicenter Registry in Asia. Journal of the American College of Cardiology. 2013; 61(10_S).
Stone GW, Kandzari DE, Mehran R, Colombo A, Schwartz RS, Bailey S, et al. Percutaneous Recanalization of Chronically Occluded Coronary Arteries A Consensus Document: Part I. Circulation. 2005;112(15):2364-72.
How to Cite
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work’s authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal’s published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).