Author + information
- Received August 8, 2010
- Revision received December 6, 2010
- Accepted December 9, 2010
- Published online March 1, 2011.
- Francesco Burzotta, MD, PhD⁎ (, )
- Carlo Trani, MD,
- Daniel Todaro, MD,
- Luca Mariani, MD,
- Giovanni Paolo Talarico, MD,
- Antonella Tommasino, MD,
- Maura Giammarinaro, MD,
- Giampaolo Niccoli, MD, PhD,
- Italo Porto, MD, PhD,
- Antonio Maria Leone, MD, PhD,
- Rocco Mongiardo, MD,
- Mario Attilio Mazzari, MD,
- Giovanni Schiavoni, MD and
- Filippo Crea, MD
- ↵⁎Reprint requests and correspondence:
Dr. Francesco Burzotta, L.go Gemelli 1, 00168 Rome, Italy
Objectives This study sought to compare the procedural performance and the acute angiographic result on side-branch ostium obtained using 2 different drug-eluting stents (DES) to treat patients with bifurcated coronary lesions.
Background Drug-eluting stents are routinely used in percutaneous coronary interventions (PCI) of bifurcated coronary lesions. Different DES types have major technical differences that may influence the procedural and clinical performance in bifurcation PCI.
Methods Consecutive patients with bifurcated lesions undergoing DES implantation using a systematic provisional-stenting strategy were randomized to sirolimus-eluting stent (SES) or everolimus-eluting stent (EES) before intervention. The procedural details for PCI were prospectively recorded to assess the occurrence of any trouble in the side-branch (SB) management (primary end point). Post-PCI angiographic result (primary end point: minimal lumen diameter at SB ostium) was evaluated offline by 3-dimensional reconstruction and quantitative coronary analysis. Clinical outcome was prospectively recorded up to 18 months to assess the occurrence of target bifurcation failure.
Results A total of 150 patients were enrolled in the study (29% diabetics, 17% unprotected left main). The stent was successfully implanted according to randomization in all cases. Procedural performance was not significantly different between the 2 kinds of DES. Three-dimensional reconstruction and quantitative coronary analysis showed similar post-PCI results in the main vessel and better results in the SB with EES than with SES (minimal lumen diameter at SB ostium: 1.94 ± 0.72 mm vs. 1.64 ± 0.62 mm; p = 0.013). At 18 months, target bifurcation failure occurred in 7 (9.0%) of SES-treated patients versus 8 (10.7%) of EES patients (p = 0.57).
Conclusions In patients with bifurcated lesions treated by provisional stenting technique, EES compared with SES is associated with similar procedural performance and better 3-dimensional reconstruction and quantitative coronary analysis result in the SB. Both DES are associated with low rates of major adverse events and angiographic failure. (Sirolimus Versus Everolimus-Eluting Stent Randomized Assessment in Bifurcated Lesions and Clinical Significance of Residual Side-Branch Stenosis [SEA-SIDE]; NCT00697372)
The authors have reported that they have no relationships to disclose.
- Received August 8, 2010.
- Revision received December 6, 2010.
- Accepted December 9, 2010.
- American College of Cardiology Foundation