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09.04.2022 | Original articles

Outcome of a polymer-free drug-coated coronary stent in bifurcation lesions—Pilot registry with serial OCT imaging

verfasst von: Hendrik Wienemann, MD, Felix Meincke, MD, Marius Vach, MD, Christian-Hendrik Heeger, MD, Annika Meyer, Tobias Spangenberg, MD, Karl Heinz Kuck, MD, PhD, Alexander Ghanem, MD, PhD

Erschienen in: Herz | Ausgabe 4/2023

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Abstract

Background

Polymer-free and carrier-free drug-coated stents (DCS) represent a novel therapeutic option for the treatment of coronary artery disease. The objective of this pilot registry is to evaluate the safety and efficacy of DCS implantation in bifurcation lesions.

Methods

Overall, 23 consecutive patients with 24 lesions received a Biolimus A9-coated DCS for coronary bifurcation lesions. Patients were examined with quantitative coronary angiography (QCA) and optical coherence tomography (OCT) at 3–6 months of follow-up.

Results

A total of 23 patients with 24 bifurcation lesions were included in this study. Nine (33.3%) lesions of eight patients revealed angiographical target lesion failure due to in-stent restenosis (ISR). In total, 19 patients with 20 bifurcation lesions were suitable for OCT analysis. A total of 2936 struts were analyzed and 14 struts (0.47%) were classified as malapposed. The mean luminal area (mm²) was not different in lesions with ISR vs. lesions with no ISR (5.07 ± 2.0 vs. 5.73 ± 1.34, p = 0.39) at follow-up. Lesions with ISR showed higher mean neointimal burden (27.11 ± 10.59 vs. 13.93 ± 9.16%, respectively; p = 0.009). All of the patients who presented with significant ISR required percutaneous re-intervention.

Conclusions

We observed a high rate of DCS ISR in bifurcation lesions, possibly related to increased inflammation and neoatherosclerosis. The small size of the study warrants careful interpretation of our results. Larger trials are necessary to expand knowledge of these findings.

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Titel: Outcome of a polymer-free drug-coated coronary stent in bifurcation lesions—Pilot registry with serial OCT imaging
verfasst von: Hendrik Wienemann, MD
Felix Meincke, MD
Marius Vach, MD
Christian-Hendrik Heeger, MD
Annika Meyer
Tobias Spangenberg, MD
Karl Heinz Kuck, MD, PhD
Alexander Ghanem, MD, PhD
Publikationsdatum: 09.04.2022
Verlag: Springer Medizin
Erschienen in: Herz / Ausgabe 4/2023
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-022-05109-7

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Outcome of a polymer-free drug-coated coronary stent in bifurcation lesions—Pilot registry with serial OCT imaging