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Crush Stenting With Paclitaxel-Eluting or Sirolimus-Eluting Stents for the Treatment of Coronary Bifurcation Lesions

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, chmengx{at}126.com

Junjie Zhang, MD

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing

Fei Ye, MD

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing

Zhongsheng Zhu, MD

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing

Song Lin, MD

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing

Nailiang Tian, MD

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing

Zhizhong Liu, MD

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing

Weiyi Fang, MD

Department of Cardiology, Shanghai Chest Hospital, Shanghai

Yundai Chen, MD

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

Xuewen Sun, MD

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing

Tak W. Kwan, MD, FACC, FACA

Department of Cardiology, Beth Israel Medical Center, New York

Two hundred forty-six patients with 252 bifurcation lesions were enrolled into a prospective, nonrandomized study to use paclitaxel-eluting or sirolimus-eluting stent for crush stenting in the treatment of coronary bifurcation lesions. Compared with the sirolimus-eluting stent group, the paclitaxel-eluting stent group had significantly higher mean late lumen and binary angiographic restenosis rates. Sirolimus-eluting stent versus paclitaxel-eluting stent recipients had significantly lower in-segment restenosis in the entire main vessel (15.7% vs 3.1%, P = .004), and simultaneous side branch and main vessel restenoses were solely detected in the paclitaxel-eluting stent group (11.9% vs 0%, P = .03). Target-lesion vessel revascularization and cumulative major adverse cardiac events rates were significantly higher in the paclitaxel-eluting versus the sirolimus-eluting stent group (17.99% vs 8.41%, P = .01; 19.4 vs 9.3%, P = .01; 23.6 vs 11.2%, P = .03). In this study with crush stenting, use of sirolimus-eluting stent, compared with paclitaxel-eluting stent, yielded significantly lower late lumen loss, restenosis, and revascularization rates, with comparable safety by 8-month follow-up.

Key Words: coronary artery disease • percutaneous coronary intervention • bifurcation lesions

This version was published on August 1, 2008

Angiology, Vol. 59, No. 4, 475-483 (2008)
DOI: 10.1177/0003319707312519


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