Effectiveness of sirolimus-eluting stent implantation for the treatment of ostial left anterior descending artery stenosis with intravascular ultrasound guidance

Ki Bae Seung, Young Hak Kim, Duk Woo Park, Bong Ki Lee, Cheol Whan Lee, Myeong Ki Hong, Pum Joon Kim, Wook Sung Chung, Seung Jea Tahk, Seong Wook Park, Seung Jung Park

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

OBJECTIVES: This study was designed to evaluate the clinical and angiographic outcomes of sirolimus-eluting stent (SES) implantation for ostial left anterior descending (LAD) lesions compared with bare-metal stent (BMS) implantation. BACKGROUND: The effectiveness of SES implantation for ostial LAD lesions is currently unknown. METHODS: Sirolimus-eluting stents were implanted in 68 consecutive patients with ostial LAD stenoses. The control group was composed of 77 patients treated with BMS during the preceding two years. In the SES group, for complete lesion coverage, stent positioning was intentionally extended into the distal left main coronary artery (LMCA) in 23 patients (34%) with intermediate LMCA narrowing. RESULTS: Compared with the BMS group, the SES group had more multivessel involvement, received fewer debulking atherectomies, underwent more direct stenting, had a greater number of stents, and had more segments stented. The procedural success rate was 100% in both groups. The six-month angiographic restenosis rate was significantly lower in the SES group than in the BMS group (5.1% vs. 32.3%, p < 0.001). During the one-year follow-up period, neither death nor myocardial infarction occurred in either group, but target lesion revascularization was less frequent in the SES group than in the BMS group (0% vs. 17%, p < 0.001). In the SES group, there were no restenoses in cases with LMCA coverage, compared with three restenoses (7.9%) in cases with precise stent positioning (p = NS). CONCLUSIONS: Sirolimus-eluting stent implantation in ostial LAD lesions achieved excellent results regarding restenosis and clinical outcomes compared with BMS implantation. This finding may be associated with reduced neointimal hyperplasia and complete lesion coverage.

Original languageEnglish
Pages (from-to)787-792
Number of pages6
JournalJournal of the American College of Cardiology
Volume46
Issue number5
DOIs
Publication statusPublished - 2005 Sep 6

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Sirolimus
Stents
Pathologic Constriction
Arteries
Therapeutics
Metals
Coronary Vessels
Atherectomy

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Seung, Ki Bae ; Kim, Young Hak ; Park, Duk Woo ; Lee, Bong Ki ; Lee, Cheol Whan ; Hong, Myeong Ki ; Kim, Pum Joon ; Chung, Wook Sung ; Tahk, Seung Jea ; Park, Seong Wook ; Park, Seung Jung. / Effectiveness of sirolimus-eluting stent implantation for the treatment of ostial left anterior descending artery stenosis with intravascular ultrasound guidance. In: Journal of the American College of Cardiology. 2005 ; Vol. 46, No. 5. pp. 787-792.
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title = "Effectiveness of sirolimus-eluting stent implantation for the treatment of ostial left anterior descending artery stenosis with intravascular ultrasound guidance",
abstract = "OBJECTIVES: This study was designed to evaluate the clinical and angiographic outcomes of sirolimus-eluting stent (SES) implantation for ostial left anterior descending (LAD) lesions compared with bare-metal stent (BMS) implantation. BACKGROUND: The effectiveness of SES implantation for ostial LAD lesions is currently unknown. METHODS: Sirolimus-eluting stents were implanted in 68 consecutive patients with ostial LAD stenoses. The control group was composed of 77 patients treated with BMS during the preceding two years. In the SES group, for complete lesion coverage, stent positioning was intentionally extended into the distal left main coronary artery (LMCA) in 23 patients (34{\%}) with intermediate LMCA narrowing. RESULTS: Compared with the BMS group, the SES group had more multivessel involvement, received fewer debulking atherectomies, underwent more direct stenting, had a greater number of stents, and had more segments stented. The procedural success rate was 100{\%} in both groups. The six-month angiographic restenosis rate was significantly lower in the SES group than in the BMS group (5.1{\%} vs. 32.3{\%}, p < 0.001). During the one-year follow-up period, neither death nor myocardial infarction occurred in either group, but target lesion revascularization was less frequent in the SES group than in the BMS group (0{\%} vs. 17{\%}, p < 0.001). In the SES group, there were no restenoses in cases with LMCA coverage, compared with three restenoses (7.9{\%}) in cases with precise stent positioning (p = NS). CONCLUSIONS: Sirolimus-eluting stent implantation in ostial LAD lesions achieved excellent results regarding restenosis and clinical outcomes compared with BMS implantation. This finding may be associated with reduced neointimal hyperplasia and complete lesion coverage.",
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Effectiveness of sirolimus-eluting stent implantation for the treatment of ostial left anterior descending artery stenosis with intravascular ultrasound guidance. / Seung, Ki Bae; Kim, Young Hak; Park, Duk Woo; Lee, Bong Ki; Lee, Cheol Whan; Hong, Myeong Ki; Kim, Pum Joon; Chung, Wook Sung; Tahk, Seung Jea; Park, Seong Wook; Park, Seung Jung.

In: Journal of the American College of Cardiology, Vol. 46, No. 5, 06.09.2005, p. 787-792.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effectiveness of sirolimus-eluting stent implantation for the treatment of ostial left anterior descending artery stenosis with intravascular ultrasound guidance

AU - Seung, Ki Bae

AU - Kim, Young Hak

AU - Park, Duk Woo

AU - Lee, Bong Ki

AU - Lee, Cheol Whan

AU - Hong, Myeong Ki

AU - Kim, Pum Joon

AU - Chung, Wook Sung

AU - Tahk, Seung Jea

AU - Park, Seong Wook

AU - Park, Seung Jung

PY - 2005/9/6

Y1 - 2005/9/6

N2 - OBJECTIVES: This study was designed to evaluate the clinical and angiographic outcomes of sirolimus-eluting stent (SES) implantation for ostial left anterior descending (LAD) lesions compared with bare-metal stent (BMS) implantation. BACKGROUND: The effectiveness of SES implantation for ostial LAD lesions is currently unknown. METHODS: Sirolimus-eluting stents were implanted in 68 consecutive patients with ostial LAD stenoses. The control group was composed of 77 patients treated with BMS during the preceding two years. In the SES group, for complete lesion coverage, stent positioning was intentionally extended into the distal left main coronary artery (LMCA) in 23 patients (34%) with intermediate LMCA narrowing. RESULTS: Compared with the BMS group, the SES group had more multivessel involvement, received fewer debulking atherectomies, underwent more direct stenting, had a greater number of stents, and had more segments stented. The procedural success rate was 100% in both groups. The six-month angiographic restenosis rate was significantly lower in the SES group than in the BMS group (5.1% vs. 32.3%, p < 0.001). During the one-year follow-up period, neither death nor myocardial infarction occurred in either group, but target lesion revascularization was less frequent in the SES group than in the BMS group (0% vs. 17%, p < 0.001). In the SES group, there were no restenoses in cases with LMCA coverage, compared with three restenoses (7.9%) in cases with precise stent positioning (p = NS). CONCLUSIONS: Sirolimus-eluting stent implantation in ostial LAD lesions achieved excellent results regarding restenosis and clinical outcomes compared with BMS implantation. This finding may be associated with reduced neointimal hyperplasia and complete lesion coverage.

AB - OBJECTIVES: This study was designed to evaluate the clinical and angiographic outcomes of sirolimus-eluting stent (SES) implantation for ostial left anterior descending (LAD) lesions compared with bare-metal stent (BMS) implantation. BACKGROUND: The effectiveness of SES implantation for ostial LAD lesions is currently unknown. METHODS: Sirolimus-eluting stents were implanted in 68 consecutive patients with ostial LAD stenoses. The control group was composed of 77 patients treated with BMS during the preceding two years. In the SES group, for complete lesion coverage, stent positioning was intentionally extended into the distal left main coronary artery (LMCA) in 23 patients (34%) with intermediate LMCA narrowing. RESULTS: Compared with the BMS group, the SES group had more multivessel involvement, received fewer debulking atherectomies, underwent more direct stenting, had a greater number of stents, and had more segments stented. The procedural success rate was 100% in both groups. The six-month angiographic restenosis rate was significantly lower in the SES group than in the BMS group (5.1% vs. 32.3%, p < 0.001). During the one-year follow-up period, neither death nor myocardial infarction occurred in either group, but target lesion revascularization was less frequent in the SES group than in the BMS group (0% vs. 17%, p < 0.001). In the SES group, there were no restenoses in cases with LMCA coverage, compared with three restenoses (7.9%) in cases with precise stent positioning (p = NS). CONCLUSIONS: Sirolimus-eluting stent implantation in ostial LAD lesions achieved excellent results regarding restenosis and clinical outcomes compared with BMS implantation. This finding may be associated with reduced neointimal hyperplasia and complete lesion coverage.

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