Treatment of multilesion coronary artery disease with simultaneous drug-eluting and bare-metal stent implantation: clinical follow up and angiographic mid-term results

J Invasive Cardiol. 2009 Apr;21(4):145-50.

Abstract

Objectives: We sought to evaluate clinical and angiographic outcomes of percutaneous coronary intervention (PCI) in patients receiving both bare-metal stents (BMS) and drug-eluting stents (DES).

Background: Few data are available about the safety and efficacy of the practice namely called "hybrid PCI".

Methods: One hundred and eighty-six patients, 502 de novo lesions, received during PCI both BMS (n = 266) and DES (316), with a mean of 3.1 +/- 1.2 stents/patient. Cumulative major adverse cardiac events were analyzed at 24 +/- 22 months.

Results: Clinical follow up was carried out in 100% of eligible patients. Angiographic follow up at 8.6 +/- 4.4 months was achieved in 70.4% of patients, 71.6% of stents and 72.5% of lesions. Binary restenosis was 12.9% vs. 20.6% (p = 0.034) in DES vs. BMS, respectively; late loss was significantly higher in BMS than in DES (0.67 +/- 0.73 vs. 0.35 +/- 0.71 mm; p < 0.001). DES showed less lumen loss and binary restenosis rates than BMS in B2/C lesions (p < 0.001 and 0.007, respectively), while any significant difference was detected in A/B1 lesions (p = 0.27 and 0.76, respectively).

Conclusions: The simultaneous use of DES and BMS is safe and provides similar results for the 2 stents only in simple lesions. In complex lesions, BMS offer restenosis and a target lesion revascularization rates significantly higher than with DES.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abciximab
  • Adult
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary*
  • Antibodies, Monoclonal / therapeutic use
  • Anticoagulants / therapeutic use
  • Aspirin / therapeutic use
  • Clopidogrel
  • Coronary Angiography*
  • Coronary Artery Disease / drug therapy
  • Coronary Artery Disease / therapy*
  • Coronary Restenosis / prevention & control
  • Coronary Vessels / pathology*
  • Databases as Topic
  • Drug-Eluting Stents / adverse effects*
  • Drug-Related Side Effects and Adverse Reactions
  • Female
  • Heparin / therapeutic use
  • Humans
  • Immunoglobulin Fab Fragments / therapeutic use
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Retrospective Studies
  • Stents / adverse effects
  • Ticlopidine / analogs & derivatives
  • Ticlopidine / therapeutic use
  • Time Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Anticoagulants
  • Immunoglobulin Fab Fragments
  • Platelet Aggregation Inhibitors
  • Heparin
  • Clopidogrel
  • Ticlopidine
  • Aspirin
  • Abciximab