【論文摘要】Clinical Outcomes of Ultrathin Bioresorbable Polymer Sirolimus-eluting Stents in Small Vessel Disease: A Retrospective Cohort Study

Shih-Wei Meng ； Cheng-Hsuan Tsai ； Ying-Hsien Chen ； Hsien-Li Kao

《海峽循環醫學雜誌》 1卷2S期 (2019/09) Pp. 225-227

https://doi.org/10.6907/SCJ.201909/SP_1(2).0188

摘要

Background/Synopsis: The percutaneous coronary intervention (PCI) in small vessel disease remains to be a challenge due to higher restenosis rate. Ultrathin bioresorbable polymer sirolimus-eluting stents (SES), Orsiro stent, has the thinner strut thickness and theoretically having the lower restenosis rate. Objectives/Purpose: We aimed to evaluate the long-term outcomes of SES in small vessel coronary artery disease. Methods/Results: We conducted a retrospective analysis in consecutive coronary artery disease patients who received PCI and SES in the National Taiwan University Hospital from January 2017 to December 2017. Total 297 SESs were deployed in 191 patients. These patients were divided to 2 groups by lesion diameters. There were 85 patients in small vessel disease (vessel size ≤2.5mm) group and 106 patients in the non-small vessel disease group. We followed up these patients up to 2 years. The primary measure is clinical driven target lesion revascularization (TLR). The secondary measure is the composite endpoints of major cardiovascular events (MACEs) including clinical driven TLR, myocardial infarction, cerebral vascular disease, heart failure admission and cardiovascular mortality. The procedure success rate was 100% and the rate of IVUS use was 57.4%. The periprocedural complication rate was 2.1%. After median 17.1 months follow-up, the cumulative incidences of TLR were 4.0 %, 2.9% and 4.4% in all patients, small vessel group and non-small vessel group, respectively (P=0.317). The cumulative incidences of MACEs were 9.3%, 6.3% and 11.2% in all patients, small vessel group and non-small vessel group, respectively (P=0.152). Conclusion: In this study, bioresorbable-polymer SES is safe and effective for treating lesions in small coronary arteries with favorable long-term outcomes.