Angiographic late lumen loss at the site of overlap of multiple Cypher (TM) sirolimus-eluting stents: ALSOCE study

作者：Takamiya Yosuke; Miura Shin ichiro; Tsuchiya Yoshihiro; Fukuda Yusuke; Zhang Bo; Kuwano Takashi; Ike Amane; Yanagi Daizaburo; Kubota Kazumitsu; Mori Ken; Iwata Atsushi; Nishikawa Hiroaki; Kawamura Akira; Miller Nathan; Matsuo Kunihiro; Shirai Kazuyuki; Saku Keijiro^*

来源：Journal of Cardiology, 2011, 57(2): 187-193.

DOI：10.1016/j.jjcc.2010.11.005

• In-stent late lumen loss
• Overlapping stent
• Sirolimus-eluting stent

Objectives: It has been reported that the overlap of sirolimus-eluting stents (SESs) is associated with greater in-stent late lumen loss and more angiographic restenosis. The purpose of this study was to evaluate whether the site of such overlap shows increased or decreased late lumen loss as assessed by quantitative coronary angiogram.
Methods and results: We compared 7-month angiographic late lumen loss at the site of overlap in patients with multiple overlapping stents (overlap SES group, n=48) to that in patients with single stents (single SES group, n=144). With regard to baseline angiographic characteristics and procedural results, there were significant differences between the overlap SES group and the single SES group in lesion complexity, lesion length and reference diameter, minimal Lumen diameter, and mean stent length. In-stent late lumen loss at the 7-month follow-up did not differ significantly between the two groups (overlap SES 0.25 +/- 0.61 mm vs. single SES 0.10 +/- 0.55 mm, p=0.11). Furthermore, the site of overlap in the overlap SES group did not show greater late lumen loss compared to the stented area in the single SES group (0.17 +/- 0.55 mm vs. 0.10 +/- 0.55 mm, p = 0.43). The overlap SES group tended to be associated with an increase in binary restenosis compared with the single SES group (22.8% vs. 12.8%, p = 0.08), while this value was 4.2% at the site of overlap. There were no significant differences in death, myocardial infarction, target lesion revascularization, or stent thrombosis between the two groups. In addition, stent length was the most independent factor of late lumen loss in the overlap SES group by multivariate logistic analysis, whereas it was not an independent factor of late lumen loss of the SES overlap segment.
Conclusions: The site of overlap of overlapping SES dose not associate with greater late lumen loss or a higher in-stent binary restenosis rate compared to single SES implantation. The overlapping of SES by itself did not increase in-stent late lumen loss.

• 出版日期2011-3