AS-216 Angiographic and Clinical Outcomes following Everolimus- versus Sirolimus-eluting Stents Implantation in Chronic Total Occlusion Intervention

April 24 –27, 2012 planted stents as 58⫾14mm (41-112 mm) and 2.2 stents were implanted in each lesion and the average stent diameter was 3.0⫾0.3 mm. Study endpoints were major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR) and stent thrombosis (ST) for 6 years after index PCI. Results: Procedural and angiographic success were achieved in all patients. After procedure, Non-Q wave MI (CK-MBⱖ3 times normal value) was developed in 13 patients (11.5 %). A six months follow up angiography was performed on 76 patients (67 %) and angiographic binary restenosis was developed in 7 patients (9.2 %). All of them were focal type in-stent restenosis and found at the distal stents. Two patients (1.8 %) had a late ST at 12 months. There were two sudden cardiac death (1.8%), one non Q-wave MI (0.9 %) and six TLR (5.3%) at 12 months. Mean follow-up duration was 1684⫾866 days. There were 4 sudden cardiac death (3.5 %), 7 non Q-wave MI (6.2 %), 6 STEMI(5.3 %), 14 TLR (12.4%), 20 TVR (17.7%), 2 CABG (1.8%), 2 late ST(1.8%) and 3 very late ST(2.7%). The major adverse cardiac events (MACE)-free survival was 94 % at 12 months, 83 % at 3 years and 73 % at 6 years. Conclusion: Long term clinical outcomes of patients with diffuse long coronary lesion treated SES for 6 years were acceptable in the “real world” practice.

AS-215 Incidence and Clinical Impact of Stent Fracture after Everolimus-Eluting Stent. Shoichi Kuramitsu1, Masashi Iwabuchi1, Takuya Haraguchi2, Ayumu Nagae2, Yoshio Kazuno1, Soichiro Enomoto1, Toru Mazaki1, Takenori Domei1, Makoto Hyodo1, Yoshimitsu Soga1, Shinichi Shirai1, Koyu Sakai1, Yoshitaka Takabatake2, Hiroyoshi Yokoi1, Fumitoshi Toyota2, Hideyuki Nosaka1, Masakiyo Nobuyoshi1. 1Kokura Memorial Hospital, Kitakyushu, Japan; 2Chidoribashi Hospital, Fukuoka, Japan.

AS-216 Angiographic and Clinical Outcomes following Everolimusversus Sirolimus-eluting Stents Implantation in Chronic Total Occlusion Intervention. Seung-Woon Rha, Amro Elnagar, Se Yeon Choi, Byoung Geol Choi, Sung Il Im, SunWon Kim, Jin Oh Na, Seong Woo Han, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Hong Seog Seo, Chang Gyu Park, Dong Joo Oh. Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea (Republic of). Background: Newer drug-eluting stents (DES) are developed with hope of improving efficacy and safety. However, whether everolimuseluting stents (EES) may provide better angiographic and clinical outcomes compared with sirolimus-eluting stents (SES) in patients (pts) with chronic total occlusions (CTO) is undetermined. Methods: A total 80 consecutive pts who underwent CTO intervention with DESs were enrolled for this study. We compared 6-month angiographic and 12-month clinical outcomes between SES group (Cypher, n⫽48) and EES group (Xience, Promus, Promus Element, n⫽32) after successful CTO intervention. Patients treated with two different DESs were excluded. Results: Baseline characteristics were similar between the two groups. At index, angiographic, procedural parameters and complications were similar between the two groups, except lesion length was longer in SES group (29.22⫾5.56 vs.25.39⫾5.73, p⫽0.003). Six months angiographic outcomes were similar between the two groups, Similar results were found at twelve months cumulative clinical outcomes (Table). Conclusion: In pts undergoing CTO intervention, EES showed similar mid-term angiographic and 1-year clinical outcomes as compared with SES.

P O S T E R

Background: Stent fracture (SF) has currently become an important concern after drug-eluting stent (DES) implantation. Recent clinical trials have demonstrated improved safety and efficacy of everolimuseluting stent (EES) as compared with first-generation DES. However, the incidence of SF with EES has never been elucidated. We sought to assess the incidence and clinical impact of SF after EES implantation. Methods: From February 2010 and January 2011, a total of 971 patients in 1218 lesions were treated solely with EES. Among 971 patients, 808 patients with 1011 lesions (83.0%) underwent follow-up angiography 6 to 9 months after index procedure. SF was defined as a complete or partial separation of the stent on plain fluoroscopy, and/or intravascular ultrasound at follow-up. We assessed the major adverse cardiac events (MACE) at 9-month defined as cardiac death, myocardial infarction, and target lesion revascularization (TLR) in patients with and without SF. Results: SF was observed in 30 patients of 31 lesions (3.0%). The rate of ISR and target lesion revacularization (TLR) were significantly higher in SF lesions than in non-SF (91.4% versus 6.4%, p⬍0.001; 85.2% versus 5.2%, p⬍0.001, respectively). MACE rate at 9-month was significantly in patients with SF higher than those without SF (74.2% versus 5.6%, p⬍0.001). Conclusion: SF after EES implantation is rare, whereas it is associated with high MACE rate, especially high TLR rate.

The American Journal of Cardiology姞 APRIL 24 –27, 2012 ANGIOPLASTY SUMMIT ABSTRACTS/Poster

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