Study shows treatment with SES in CTOs results in less restenosis compared with BMS

Published date : 19 July 2010
Article date : 19 July 2010

Latest study results have shown that in chronic total occlusions (CTOs), treatment with sirolimus-eluting stents (SES) leads to less restenosis at eight months compared with bare-metal stents (BMS). Patients who receive SES also require less repeat revascularisation at two-year follow-up, according to randomised clinical trial data published online June 20, 2010, ahead of print in the European Heart Journal.

For the GISSOC II-GISE trial, researchers led by Dr Paolo Rubartelli, Ospedale Villa Scassi (Genoa, Italy), enrolled 152 patients at 13 Italian centres between May 2005 and September 2007. Patients, who all had de novo CTOs present for at least 30 days in a native coronary artery, were randomised to receive SES (n=74; Cypher, Cordis/Johnson & Johnson, Miami Lakes, FL) or BMS (n=78; Bx Sonic, Cordis). Angiographic follow-up was performed at eight months, and clinical follow-up was conducted through 24 months.

Eight-month restenosis favours SES

Angiographic follow-up was obtained at a mean of 8.4 months in 84% of the cohort. The primary endpoint of in-segment minimal lumen diameter was larger with SES treatment, which also produced less in-segment late lumen loss and binary restenosis. Total reocclusion occurred in 16.9% of BMS patients but in none of the SES patients (P = 0.001).

At 24-month follow-up, SES and BMS patients had similar rates of most clinical outcomes. The rate of MACE (defined as death, MI, emergent CABG, TLR, or TVR) was lower with SES treatment, driven mainly by a reduced need for repeat revascularisation. Angina and silent ischaemia were also less common in SES patients.

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