Tratamiento de lesiones bifurcadas con stent farmacoactivo autoexpandible específico para lesiones bifurcadas (Axxess): experiencia inicial unicéntrica

Abstract

Introduction and AimsThe Axxess stent is a nitinol self-expanding Biolimus A9™ eluting stent, that deploys at the carina, providing easy access to the distal branches. The aim of this study was to evaluate the acute performance of the device and the type of strategy intended. Methods and resultsA total of 33 ambispective consecutive patients with 34 lesions (69±9 years, 76% men, 60% smokers, 46% diabetics, 76% hypertensives, 54% hyperlipidemics, AF 27%, 36% previous IHD and 24% previous PCI) were included in our center. A percentage of 33 had depresed LVEF. The clinical presentation was ACS in all cases (45.5% UA; 36.4% NSTEMI, 18.2% STEMI). The access was 97% by radial approach (7F or 6F). The bifurcation treated was: 70.6% LAD-Diagonal; 11,8% ACx-OM; 2,9% RCA-PLB; 14,7% LM-LAD-ACx. There were 80.6% of true bifurcations lesions and the most frequent type was Medina 1,1,1 (74%). The bifurcation angle was less than 70° in 70.6% of patients. In 29.4% (n=10) only an Axxess was implanted, 35.3% Axxess+MB stent, 20.6% Axxess+SB stent and in only 14.7% were necessary implant Axxess+MB+SB stents. All stents used were Biolimus eluting stents. Predilatation/postdilatation was done in 100/97% respectively. During a mean follow-up of 494±229 days there was a MACE rate of 2.9% (TLR). ConclusionsThe Axxess stent performed well, offering a unique approach to bifurcation treatment and excellent results in a mid-long term follow up.