Clinical outcomes after PCI treatment of very long lesions with the XIENCE V everolimus eluting stent; Pooled analysis from the SPIRIT and XIENCE V USA prospective multicenter trials. Issue 6 (22nd August 2016)

• Record Type: Journal Article
• Authors: Bouras, Georgios; Jhamnani, Sunny; Ng, Vivian G.; Haimi, Ido; Mao, Vivian; Deible, Regina; Cao, Sherry; Sudhir, Krishnankutty; Lansky, Alexandra J.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 89:Issue 6(2017)
• Page Start: 984
• Page End: 991
• Publication Date: 2016-08-22
• Subjects: drug‐eluting stent -- long coronary lesion -- overlapped stents -- percutaneous coronary intervention; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.26711
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract : Background: 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. Methods: We performed a patient level pooled analysis of 13, 266 patients undergoing planned overlapping stent treatment of very long coronary lesions with the XIENCE V everolimus eluting coronary stent system 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 (lesions ≥35 mm) and a control group (lesions >24 to <35 mm). 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. Results: 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 ± 13.7 mm in the VLL group which were compared to controls comprised of 3.6% of the cohort (482 patients with 500 total lesions) with mean lesion length of 28.1 ± 2.4 mm.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) at 1 year. Conclusions: In the treatment of very long coronary lesions, the XIENCE V stent appears as safe and effective as percutaneous coronary interventions for long lesions. © 2016 Wiley Periodicals, Inc.