Study reveals effectiveness of drug-eluting stents in treating chronic total occlusions

A multicenter study in Asia found drug-eluting stents effective with a low rate of acute complications in patients with chronic total occlusions (CTOs) undergoing PCI. Results of the study will be presented at the 21st annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, sponsored by the Cardiovascular Research Foundation (CRF).

The aim of the study, "Drug-Eluting Stents for the Treatment of Chronic Total Occlusion: A Comparison with Sirolimus (SES), Paclitaxel (PES), Zotarolimus (ZES), Biolimus A9 (BES), EPC Capture (ECS) and Everolimus-Eluting Stent (EES): Multicenter Registry in Asia" is to compare the safety and efficacy of SES, PES, ZES, BES, SCS and EES in the treatment of patients with chronic total occlusion (blockage) of cardiac blood vessels. The study will be presented as a poster abstract (TCT-234) on Tuesday, September 22 between 8:00 a.m. and 10:00 a.m. in Hall D of The Moscone Center.

For the study, researchers led by Sunao Nakamura, MD, performed a prospective analysis of 1,148 patients with 1,253 CTOs treated with different drug-eluting stents (396 SES, 526 PES, 177 ZES, 66 BES, 41 ECS, and 43 EES) in six high volume Asian centers after successful CTO re-canalization was performed.

Dr. Nakamura, who will report on the results of the investigations, is Vice President and Director of the Cardiovascular Center at New Tokyo Hospital as well as Clinical and Visiting Professor of Kumamoto University in Matsudo, Japan.

The researchers found that the incidence of major adverse cardiac events (MACE) at 30 days was nearly non-existent in patients with CTO lesions treated with drug-eluting stents (0.4% in patients with PES, 0.6% in ZES and 0% in all other categories). MACE at 9 months was 3.6% for those receiving SES, 6.7% for PES, 10.4% for ZES, 4.5% for BES, 10.3% for ECS and 2.4% for EES. Target lesion revascularization (TLR) at 9 months was 3.6% for patients who received SES, 6.7% for PES, 10.4% for ZES, 4.5% for BES, 10.3% for ECS and 2.4% for EES.

In addition, patients treated with SES, BES and EES showed a lesser rate of angiographic restenosis compared with other drug-eluting stents at 9 months (4.0% restenosis for patients receiving SES, 6.7% for PES, 12.3% for ZES, 4.5% for BES, 10.3% for ECS and 2.4% for EES).

In conclusion, Dr. Nakamura noted that, "The study indicates a good clinical performance of the new BES and EES devices."