Abstract
BACKGROUND:Despite significant improvements in stent platform, currently available bare-metal stents (BMS) are still associated with restenosis. Thin-strut design cobalt-chromium alloys hold the promise of improving results of BMS, especially when implanted with direct technique. We performed an observational study to appraise outcomes of the novel Skylor™ stent, stratifying outcomes according to stenting technique.METHODS and RESULTS:We included all consecutive patients undergoing coronary stenting with Skylor™ at 2 centers between 2006 and 2009. The primary end-point was the long-term rate of major adverse cardiac events (MACE, i.e. death, myocardial infarction (MI), coronary artery bypass grafting (CABG) or target vessel revascularization (TVR)). As pre-specified analysis, we compared patients undergoing direct stenting versus those stent implantation following pre-dilation. A total of 1020 patients were included (1292 Skylor™ stents), with procedural success obtained in 99%. Comparing patients undergoing direct stenting (66%) versus pre-dilation (34%) at 16±7 months of follow-up, MACE had occurred in, respectively, 8% versus 14% (p=0.001), with death in 1% versus 2% (p=0.380), MI in 1% versus 2% (p=0.032), CABG in 0.2% versus 2% (p=0.012), and TVR in 6% versus 9% [p=0.071]. Even at multivariable analysis with propensity adjustment, direct stenting was associated with significantly fewer MACE [hazard ratio 0.60 [0.38-0.93], p=0.024].CONCLUSIONS:This observational study suggests the presence of a beneficial synergy between direct coronary stenting technique and use of the novel thin-strut cobalt-chromium Skylor™ stent in real-world patients undergoing PCI.
Highlights
Despite ongoing evidence for the benefits of medical therapy in low or moderate risk patients [1,2], and coronary artery bypass grafting (CABG) in high-risk patients [2,3], percutaneous coronary intervention (PCI) maintains an important clinical role in patients with stable coronary disease failing best medical therapy and those with unstable coronary disease [4].Drug-eluting stents (DES) have been proved significantly superior to stainless-steel bare-metal stents (BMS) [5], but their premium efficacy in comparison to more sophisticated BMS has been questioned, especially in patients and lesions at lower risk of restenosis or higher risk of thrombosis [6,7]
This observational study suggests the presence of a beneficial synergy between direct coronary stenting technique and use of the novel thin-strut cobalt-chromium SkylorTM stent in real-world patients undergoing PCI
A direct stenting technique was more frequently performed in younger patients (p=0.001), and in those with fewer lesions (p=0.027), whereas pre-dilation was more frequent in those being treated in the left main (p=0.013), with tortuous vessels (p=0.009), small vessels (p
Summary
Drug-eluting stents (DES) have been proved significantly superior to stainless-steel bare-metal stents (BMS) [5], but their premium efficacy in comparison to more sophisticated BMS has been questioned, especially in patients and lesions at lower risk of restenosis or higher risk of thrombosis [6,7]. Despite significant improvements in stent platform and alloys, currently available BMS are still associated with restenosis [5,6]. Thin-strut designs and cobalt-chromium alloys have been suggested to improve. Despite significant improvements in stent platform, currently available bare-metal stents (BMS) are still associated with restenosis. Thin-strut design cobalt-chromium alloys hold the promise of improving results of BMS, especially when implanted with direct technique. We performed an observational study to appraise outcomes of the novel SkylorTM stent, stratifying outcomes according to stenting technique
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
