e0506 Application of overlapped sirolimus-eluting stents in treatment of long coronary arteries lesion

Objective To evaluate the clinical efficacy of overlapped Excel and Cypher stents in treatment for long coronary arteries lesion. Method 374 patients with de-novo long coronary arteries lesion who performed 2 Excel or Cypher stents which diameter varied 2.5 mm ∼ 3.5 mm in department of cardiology, general hospital of CAPF were enrolled in from 2006.8 to 2009.3 retrospectively. These patients were divided to two groups by the type of stents implanted: Excel group and Cypher group. The incidence of composite MACE and stent thrombosis during hospitalisation and 12-month clinical follow-up outside hospital after PCI between two groups were compared, follow-up angiograpy were performed in several patients, and in-stent LLL, in-segemt LLL and incidence of restenosis between two groups were compared. Result Clinical characteristics and characteristics of target lesion were similar between two groups, PCI procedure were similar except the ratio of pre-dilatation between two groups. Incidence of composite MACE during hospitalisation after PCI of Excel group and Cypher group were 5.7% and 6.1%, incidence of composite MACE 12-month clinical follow-up outside hospital were 6.6% and 8.8% respectively, incidence of acute/subacute stent thrombosis defined by ARC of Excel group and Cypher group were 2.8% and 2.5%, incidence of late stent thrombosis were 2.7% and 2.7% respectively, there were no significant differences between two groups; incidence of in-stent restenosis of Excel group and Cypher group follow-up were 6.0% and 9.6%, incidence of in-segment restenosis were 9.5% and 12% respectively, that revealed non-significant differences between two groups; in-segment LLL of Excel group and Cypher group were 0.11±0.06 mm and 0.12±0.08 mm, there were no significant differences between two groups, but in-stent LLL were 0.09±0.05 mm and 0.10±0.05 mm respectively, that showed significant difference between two groups (p=0.037). Conclusion The safety and efficacy of overlapped Excel stents were similar as overlapped Cypher stents in treatment of long coronary arteries lesion, meanwhile, overlapped Excel stents relieve in-stent LLL than overlapped Cypher stents; LLL of overlapped site was more severe than non-overlapped site, whatever Excel or Cypher stents, but there was no significant difference in ratio of restenosis between overlapped site and any other regions.