Stentys' Self-Expandable SES Evaluated to Treat Unprotected Left Main Coronary Artery
October 8, 2018—Antonio Montefusco, MD, et al published findings from a study that sought to compare the effectiveness and safety of Stentys' self‐expandable, sirolimus‐eluting stents (SES) versus second‐generation drug‐eluting stents (DES‐II) for the treatment of the unprotected left main coronary artery. The study is available online in Catheterization and Cardiovascular Interventions.
The investigators noted that the background of the study is that SES may provide a valuable option to treat distal unprotected left main coronary artery, particularly when significant caliber gaps with side branches are observed.
As summarized in Catheterization and Cardiovascular Interventions, the study was composed of patients from SPARTA, the multicenter Self-Apposing Stentys Stents Registry, and the FAILS2 registry.
The investigators performed a propensity‐score analysis with matching to account for the lack of randomization. The primary endpoint was the rate of major adverse cardiovascular events (MACE, a composite of all-cause death, myocardial infarction, target lesion revascularization [TLR], unstable angina, and definite stent thrombosis). Single components of MACE were the secondary endpoints.
Overall, 151 patients treated with SES and 1,270 with DES‐II were included; no differences in MACE rate at 250 days were observed (9.8% vs 11.5%; P = 0.54). After propensity score with matching, 129 patients treated with SES and 258 with DES‐II, of which about one-third were women, were compared.
After a follow‐up of 250 days, there was no difference between the two groups in the following:
- MACE rate (9.9% vs 8.5%; P = .66)
- Unprotected left main coronary artery TLR rate (1.6% vs 3.1%; P = .36)
- Definite stent thrombosis (0.8% vs 1.2%; P = .78)
These results were consistent also when controlling for the treatment with provisional versus two‐stent strategies for the unprotected left main coronary artery bifurcation.
SES use for unprotected left main coronary artery treatment was associated with a similar MACE rate compared with DES‐II at an intermediate‐term follow‐up and might represent a potential option in this setting, concluded the investigators in Catheterization and Cardiovascular Interventions.