Initial and late efficacy of everolimus-eluting stents for small and non-small coronary lesions from evaluating delayed late loss study.

Abstract

The aim of the present study was to evaluate the long-term outcomes at 2years in patients in whom everolimus-eluting stents (EESs) were implanted in small and non-small vessels. A small vessel is an important risk factor for restenosis with BMSs, even in the first generation DESs. The 690 patients with 690 lesions implanted with an EES were enrolled and divided into two groups by vessel reference diameter (RD): >2.5mm for non-small vessels (Non-S-group) and ≤2.5mm for small vessels (S-group). Two years later, the 365 patients with no restenosis at 8months who underwent angiography were enrolled into the late catch-up study. At the initial 8-month follow-up, the rates of restenosis and target lesion revascularization (TLR) of both groups were not significantly different (restenosis 3.9 vs 6.5%, p=0.17; TLR 3.9 vs 6.5%, p=0.17). At the late 2-year follow-up, there were no significant differences in the late loss (0.36±0.66 vs 0.34±0.50mm, p=0.14), net gain (1.50±0.75 vs 1.26±0.60mm, p=0.39), late catch-up restenosis rate (5.1 vs 3.4%, p=0.38), TLR (4.9 vs 2.7%, p=0.40), and delayed late loss (0.14±0.58 vs 0.15±0.49mm, p=0.10) between both groups. There is no correlation between delayed late loss and RD in all patients(r=-0.009) and in AMI patients (r=-0.004). These results demonstrate that the initial and late catch-up restenosis rates of small coronary vessels with EES placement were excellent, the same as for non-small coronary vessels. We suggest that involvement of small coronary arteries may not be a risk factor for restenosis and results of stenting for small coronary arteries with EES placement were excellent.