Author + information
- S1936879815020750-14e9cfdec6c25304ee62a6dda2252245Georgios Bouras1,
- S1936879815020750-5746bb5a6948e6ab7249d29c826bf209Sunny Jhimani1,
- S1936879815020750-aa9c58a602151aaba530da36c294aab6Ido Haimi1,
- S1936879815020750-5cef520ad82cd05f73cd8269748322abVivian G. Ng1,
- S1936879815020750-51b15462b533eda3445046877794812eVivian Mao2,
- S1936879815020750-ed7b87682534d6724c2547b42739540cRegina Deible2,
- S1936879815020750-a511ac9a6c3f7ef8b312b090e9bd3a53Sherry Cao2,
- S1936879815020750-eb87f0f3c492a49fac090208c91d69b9Krishnankutty Sudhir2 and
- S1936879815020750-93f58e87e69f3a8be883423e2b553ed9Alexandra J. Lansky1
Lesion length has been an important factor in predicting a worse outcome after percutaneous coronary interventions (PCI), however the safety and efficacy of second-generation drug eluting stents in very long coronary lesions has not been validated in large scale randomized controlled trials.
We performed a patient level pooled analysis of patients undergoing planned overlapping stent treatment of very long coronary lesions with the XIENCE V everolimus eluting coronary stent system (Xience V, Abbott Vascular, Santa Clara, CA) from 6 trials evaluating the XIENCE V stent (Spirit II, III, IV, V, Spirit Small Vessel and XIENCE V USA). Patients were divided into two cohorts, a very long lesion (VLL) group with lesions ≥35mm and a control group with lesions >24mm to <35mm. The primary outcome measures were Target Lesion Failure (TLF), Major Adverse Cardiac Events (MACE) and Academic Research Consortium (ARC) defined definite and probable stent thrombosis at 1 year.
A total of 13,266 patients were included in the pooled analysis of which 2.4% (323 patients with 328 total lesions) had a mean lesion length of 47.1±13.7mm in the VLL group and 3.6% (482 patients with 500 total lesions) had a mean lesion length of 28.1±2.4mm in the control group. At 1 year there was no significant difference in the rates of TLF between the VVL and control groups (8.9% Vs 10%, p=0.63), MACE (9.2% vs 10%, p=0.74) or stent thrombosis (1.6% Vs 1.5%, p=0.92).
In the treatment of very long coronary lesions, the XIENCE V stent appears as safe and effective as percutaneous coronary interventions for shorter lesions.