Five-year follow-up of the endothelial progenitor cell capturing stent versus the paxlitaxel-eluting stent in de novo coronary lesions with a high risk of coronary restenosis

Catheter Cardiovasc Interv. 2018 Jun;91(7):1212-1218. doi: 10.1002/ccd.27249. Epub 2017 Sep 4.

Abstract

Objectives: To assess the long-term safety and clinical efficacy of the Genous endothelial progenitor cell capturing stent (ECS) compared with the TAXUS Liberté paclitaxel-eluting stent (PES) in lesions with a high risk of restenosis.

Background: Instead of the use of cytotoxic or cytostatic drugs in drug-eluting stents, a "pro-healing" approach in ECS may overcome impeded healing response due to delayed functional endothelialization of the stent struts.

Methods: In the prospective, randomized TRIAS pilot study 193 patients with coronary artery lesions carrying a high risk of restenosis were included (ECS: n = 98, PES: n = 95). The primary focus of this analysis was target vessel failure (TVF) at 5 years. Dual antiplatelet therapy was prescribed for ≥1 month after ECS and for ≥6 months after PES.

Results: At 5 years follow-up, no significant differences were found in TVF (ECS 24% vs. PES 29%, risk difference 95% confidence interval (RDCI) -17.3% to 7.4%). Between 2 and 5 years after the index procedure, low numbers of TVF were observed in ECS compared with PES (ECS 4% vs. PES 16%, RDCI -20.8% to -2.3%). There was no definite stent thrombosis in ECS compared with four patients in the PES group.

Conclusion: This is the first randomized study providing very long-term clinical efficacy and safety of the ECS in lesions carrying a high risk of restenosis. At 5 years follow-up, TVF rates in ECS group are numerically lower compared with PES due to an increase of events between 2 and 5 years after the index procedure.

Keywords: Genous; TAXUS; percutaneous coronary intervention; restenosis; stent.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Cardiovascular Agents / administration & dosage*
  • Cardiovascular Agents / adverse effects
  • Coronary Angiography
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / etiology
  • Coronary Restenosis / pathology
  • Coronary Restenosis / prevention & control*
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / pathology
  • Coronary Stenosis / surgery*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / pathology
  • Coronary Vessels / surgery*
  • Drug-Eluting Stents*
  • Endothelial Progenitor Cells / pathology*
  • Humans
  • Paclitaxel / administration & dosage*
  • Paclitaxel / adverse effects
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Pilot Projects
  • Platelet Aggregation Inhibitors / administration & dosage
  • Prospective Studies
  • Prosthesis Design
  • Re-Epithelialization
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Platelet Aggregation Inhibitors
  • Paclitaxel