Midterm clinical outcomes of Sirolimus-versus paclitaxel-eluting stents for the treatment of bifurcation lesions

초록

Background: Angioplasty of bifurcation lesions represents a continuing challenge. Although drug-eluting stent (DES) have been shown to reduce restenosis in many types of off-labeled lesions, however it is less known that which DES is superior, in the treatment of bifurcation lesions. Method: A total of 208 patients (pts) were randomly receive either Sirolimus (SES group; n=160 pts, 183 lesions) or Paclitaxel (PES group, n=148 pts, 174 lesions) -eluting stents. PCI strategy for bifurcation lesion was mainly stent crossover, crushing stenting and kissing stenting. Clinical outcomes at 6 months were evaluated. Result: The current two groups had similar baseline clinical and procedural characteristics except SES group had larger stent diameter (3.01±0.35 vs. 2.91±0.41, p=0.013) and longer stent length (26.51±5.70 vs. 24.74±6.42, p=0.007) than those of PES group. At 6 months, the SES group had larger follow-up minimal luminal diameter (MLD), less late loss and trend toward less binary restenosis in the main branch (MB) than those of PES group. However, these two groups had similar clinical outcomes and incidence of stent thrombosis at 6 months (Table). Conclusion: Sirolimus- and paclitaxel-eluting stents had similar mid-term clinical outcomes in the treatment of bifurcation lesions regardless of bifurcation stenting strategy despite the SES substantially reduced intimal hyperplasia.