The aim of this study was to determine whether patients from the Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System in the Treatment of Patients With de Novo Native Coronary Artery Lesions (SPIRIT) IV trial who underwent percutaneous coronary intervention, who had target lesions with jailed side branches, had improved clinical outcomes when treated with the XIENCE V versus Taxus Express(2) drug-eluting stent. In the SPIRIT III randomized trial, patients with target lesions with jailed side branches after XIENCE V compared with Taxus Express(2) implantation had lower 2-year rates of major adverse cardiac events. The SPIRIT IV trial represents a larger more diverse patient population compared with SPIRIT III. In the large-scale, prospective, multicenter, randomized SPIRIT IV trial, 3,687 patients who underwent coronary stenting with up to 3 de novo native coronary artery lesions were randomized 2:1 to receive XIENCE V versus Taxus Express(2) stents. Two-year clinical outcomes of patients with or without jailed side branches after stenting were compared. A jailed side branch was defined as any side branch >1.0 mm in diameter within the target segment being stented, excluding bifurcations deemed to require treatment. Of the 3,687 patients in SPIRIT IV, a total of 1,426 had side branches that were jailed during angioplasty of the target lesion. Patients with jailed side branches after XIENCE V compared with Taxus Express(2) implantation had significantly lower 2-year rates of target lesion failure (6.5% vs 11.9%, p = 0.001), major adverse cardiac events (6.6% vs 12.2%, p = 0.0008), ischemia-driven target vessel revascularization (4.1% vs 7.9%, p = 0.004), and stent thrombosis (0.6% vs 2.8%, p = 0.001). In conclusion, patients with jailed side branches after stenting with XIENCE V compared to Taxus Express(2) devices had superior clinical outcomes at 2 years in the large-scale randomized SPIRIT IV trial.
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http://dx.doi.org/10.1016/j.amjcard.2013.01.330 | DOI Listing |
Background: Jailed wire (JW) in the side branch (SB) is recommended during coronary bifurcation provisional stenting, but real benefit is unsure. Our objective was to evaluate benefit of a JW technique in the CABRIOLET registry.
Methods: In CABRIOLET, including 500 patients, we compared the primary composite endpoint poor final SB angiographic result (TIMI flow
Cardiovasc Diagn Ther
October 2024
Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Percutaneous coronary intervention (PCI) for coronary bifurcation disease remains one of the most challenging situations in interventional cardiology in terms of procedural success rates and long-term cardiac events. Optical coherence tomography (OCT), with a higher signal-to-noise ratio and the ability to distinguish plaque components, can display the true condition of bifurcation lesions without overlapping or shortening and achieve detailed visualization of vascular structures, which is superior to those of other imaging modalities. Three-dimensional (3D) reconstruction of OCT images (3D-OCT) helps to gain a more informed understanding of the geometry and morphology of bifurcation lesions and provide additive information on plaque distribution.
View Article and Find Full Text PDFBrain Sci
September 2024
Department of Radiology, Hacettepe University, 06230 Ankara, Turkey.
The aim of this study is to present the outcomes of cerebral aneurysm treatment with the DERIVO mini Embolisation Device (DMD), which is compatible with microcatheters with 0.021-inch inner diameters. Consecutive patients treated with DMD were identified retrospectively.
View Article and Find Full Text PDFRev Cardiovasc Med
August 2024
School of Medicine, Nankai University, 300071 Tianjin, China.
Background: There is controversy regarding the effectiveness the of jailed wire technique (JWT) and jailed balloon technique (JBT) in preserving the side branch (SB) during treatment. This study compares the protective effect of JBT versus JWT on the SB ostium area in coronary bifurcation lesions using three-dimensional optical coherence tomography (3D-OCT).
Methods: We obtained data from coronary heart disease patients who received OCT-guided percutaneous coronary intervention (PCI) for bifurcation lesions.
Eur Heart J Case Rep
August 2024
Department of Cardiovascular Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo Ward, Tokyo 113-8519, Japan.
Background: Coronary stents have been reported to cause endothelial dysfunction, potentially leading to spasm at the edges of the stent. However, the clinical significance of vascular spasm in stent-jailed side branches remains poorly understood.
Case Summary: A 67-year-old woman was referred to our hospital for angina occurring both during exercise and at rest.
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