Paclitaxel eluting stents versus bare metal stents restenosis
Keywords:
stent restenosis, paclitaxel, drug eluting stent.Abstract
Introduction: The restenosis of the paclitaxel-eluting stents used in Cuba has not been studied.Objective: To evaluate the restenosis of paclitaxel-eluting stents and conventional stents.
Methods: 64 patients with stent restenosis were included, from a previous prospective study; in 318 patients followed up for 3 years after percutaneous coronary intervention; 25 with a paclitaxel-eluting stent and 39 conventional metal stent. Restenosis was considered as a new lesion ≥ 50 % of the vessel lumen with proven ischemia. The time to onset, angiographic pattern and alternative revascularization were described.
Results: Restenosis in the group with paclitaxel-eluting stents was 15.7 % with a mean survival time without restenosis of 32.4 months vs. 24.5 % in conventional stents, with restenosis-free survival of 29.8 months, (p = 0.047). In the group with paclitaxel-eluting stents, the IB pattern predominated (30.3 %) and the conventional stent III (28.3 %). In 28.0 % of the paclitaxel-eluting stent group, revascularization surgery was used vs. 5.1 % in the conventional stent group.
Conclusions: The paclitaxel-eluting stent achieves a superior and more durable restenosis-free survival than the conventional stent. Restenosis in paclitaxel-eluting stents is focal, with a higher frequency of revascularization by surgery, and in conventional stents it is mostly diffuse.
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References
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17. García E, Serra A, Zueco JJ, Larman M, Rumoroso JR, Moreu J, et al. Long-Term Clinical Performance of Paclitaxel-Eluting Stents Coated With Bioactive Polymer (P-5) Containing a Triflusal Derivative: Results of the REWAC Registry. J Invasive Cardiol 2013 [acceso: 23/09/2020]; 25(8): 391-396. Disponible en: https://www.hmpgloballearningnetwork.com/site/jic/articles/long-term-clinical-performance-paclitaxel-eluting-stents-coated-bioactive-polymer-p-5-conta
18. Resúmenes de Trabajos Libres XV Congreso Nacional de Cardiología. Rev. Mex. Cardiol. 2012 [acceso: 23/09/2020]; 23(4): 169-230. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0188-21982012000400001&lng=es
19. Núñez-Gil IJ, Vedia Ó, Pérez-Vizcayno MJ, Mejía-Rentería H, Salinas y P, Fernández-Ortiz A. Reestenosis del stent tras una intervención coronaria percutánea primaria: patrón focal frente a difuso. Influencia del perfil clínico y del tipo de stent. REC Interv Cardiol. 2020 [acceso: 23/09/2020]; 1: 64-7. Disponible en: https://www.recintervcardiol.org/es/?option=com_content&view=arti-cle&id=254&catid=21
20. Lakovou I, Schmidt T, Ge L, Sangiorgi GM, Stankovic G, Airoldi F, et al. Angiographic patterns of restenosis after paclitaxel-eluting stent implantation. Journal of the American College of Cardiology. 2005 [acceso: 23/09/2020]; 45(5):805-6. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0735109704024118
21. Byrne R, Iijima R, Mehilli J, Pache J, Schulz S, Schömig A, et al. Tratamiento de la reestenosis de stents liberadores de paclitaxel mediante implantación de stents liberadores de sirolimus. Resultados angiográficos y clínicos. Revista Española de Cardiología. 2008 [acceso: 23/09/2020]; 61(11): 1134-9. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0300893208751637
2. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, et al. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation. 2019 [acceso: 27/08/2020]; 139(10): [aprox. 40 pant.] Disponible en: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000659
3. Moussa ID, Mohananey D, Saucedo J, Stone GW, Yeh RW, Kennedy KF, et al. Trends and Outcomes of Restenosis After Coronary Stent Implantation in the United States. Journal of the American College of Cardiology. 2020 [acceso: 27/08/2020]; 76(13): 1521. Disponible en: http://www.onlinejacc.org/content/76/13/1521.abstract
4. Leyva QAY, León GM, Valdés RMA, Ponte GG, Mendoza OJL, Rodríguez BS. Factores asociados a la recurrencia de la re-estenosis intrastent coronario convencional. Rev Cub cardiol cir cardiovasc. 2015 [acceso: 27/08/2020]; 21(1): [aprox. 6 p.]. Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/564
5. Sánchez MMG, Moreno MFL, Aladro MIF, Vega FLF, Ibargollín HRS, Nodarse VJR, et al. Valoración clínica y angiográfica de la reestenosis del stent coronario convencional. CorSalud. 2017 [acceso: 27/08/2020]; 6(1):11. Disponible en: http://www.revcorsalud.sld.cu/index.php/cors/article/view/177
6. Aroche AR, Obregón SÁG, Conde CH, Hernández NM, Calderón CW, Rodríguez NAY. Reestenosis post implante de stent coronario metálico convencional. Investigaciones Medicoquirúrgicas. 2012 [acceso: 27/08/2020]; 2(2): [aprox. 5 p.]. Disponible en: http://www.revcimeq.sld.cu/index.php/imq/article/view/135
7. Aroche AR, Rodríguez NAY, García HRA, Hernández NM, Obregón SAG, Aldama PLI. Efectividad de la intervención coronaria percutánea con stent liberador de paclitaxel frente a stet convencional. Rev Cuba Cardiol Cir Cardiovasc. 2020 [acceso: 26/08/2020]; 26(3): [aprox. 0 p.]. Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/1011
8. Mehran R, Dangas G, Abizaid AS, Mintz GS, Lansky AJ, Satler LF, et al. Angiographic patterns of in-stent restenosis: classification and implications for long-term outcome. Circulation. 1999 [acceso: 26/08/2020]; 100(18):1872-8. Disponible en: https://www.ahajournals.org/doi/10.1161/01.CIR.100.18.1872
9. Kobo O, Saada M, Meisel SR, Hellou E, Frimerman A, Abu Fanne R, et al. Modern Stents: Where Are We Going? Rambam Maimonides Med J. 2020 [acceso: 23/09/2020]; 11(2):e0017. Disponible en: https://www.rmmj.org.il/issues/45/articles/1080
10. Grube E, Silber S, Hauptmann KE, Mueller R, Buellesfeld L, Gerckens U, et al. TAXUS I: Six- and Twelve-Month Results From a Randomized, Double-Blind Trial on a Slow-Release Paclitaxel-Eluting Stent for De Novo Coronary Lesions. Circulation. 2003 [acceso: 16/06/2019]; 107(1): 38-42. Disponible en: https://www.ahajournals.org/doi/10.1161/01.CIR.0000047700.58683.A1
11. Silber S, Colombo A, Banning AP, Hauptmann K, Drzewiecki J, Grube E, et al. Final 5-Year Results of the TAXUS II Trial: A Randomized Study to Assess the Effectiveness of Slow- and Moderate-Release Polymer-Based Paclitaxel-Eluting Stents for De Novo Coronary Artery Lesions. Circulation. 2009 [acceso: 16/06/2019]; 120(15): 1498-504. Disponible en: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.109.849877
12. Ellis SG, Stone GW, Cox DA, Hermiller J, O'Shaughnessy C, Mann T, et al. Long-term safety and efficacy with paclitaxel-eluting stents: 5-year final results of the TAXUS IV clinical trial (TAXUS IV-SR: Treatment of De Novo Coronary Disease Using a Single Paclitaxel-Eluting Stent). JACC: Cardiovascular Interventions. 2009 [acceso: 16/06/2019]; 2(12): 1248-59. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S1936879809006712
13. Stone GW, Ellis SG, O'Shaughnessy CD, Martin SL, Satler L, McGarry T, et al. Paclitaxel-Eluting Stents vs Vascular Brachytherapy for In-Stent Restenosis Within Bare-Metal Stents: The TAXUS V ISR Randomized Trial. JAMA. 2006 [acceso: 17/06/2019]; 295(11):1253. Disponible en: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.295.11.1253
14. Grube E, Dawkins K, Guagliumi G, Banning A, Zmudka K, Colombo A, et al. TAXUS VI final 5-year results: a multicentre, randomised trial comparing polymer-based moderate-release paclitaxel-eluting stent with a bare metal stent for treatment of long, complex coronary artery lesions. EuroIntervention. 2009 [acceso: 13/08/2020]; 4(5): 572-7. Disponible en: https://eurointervention.pcronline.com/article/taxus-vi-final-5-year-results-a-multicentre-randomised-trial-comparing-polymer-based-moderate-release-paclitaxel-eluting-stent-with-a-bare-metal-stent-for-treatment-of-long-complex-coronary-artery-lesions
15. Stone GW, Moses JW, Ellis SG, Schofer J, Dawkins KD, Morice M-C, et al. Safety and Efficacy of Sirolimus- and Paclitaxel-Eluting Coronary Stents. N Engl J Med. 2007 [acceso: 23/09/2020]; 356(10): 998-1008. Disponible en: https://doi.org/10.1056/NEJMoa067193
16. Unverdorben M, Degenhardt R, Wiemer M, Horstkotte D, Schneider H, Nienaber C, et al. The paclitaxel-eluting coroflexTM please stent study (PECOPS I): The 3-year clinical follow-up. Cathet Cardiovasc Intervent. 2009 [acceso: 23/09/2020]; 74(5): 674-82. Disponible en: http://doi.wiley.com/10.1002/ccd.22087
17. García E, Serra A, Zueco JJ, Larman M, Rumoroso JR, Moreu J, et al. Long-Term Clinical Performance of Paclitaxel-Eluting Stents Coated With Bioactive Polymer (P-5) Containing a Triflusal Derivative: Results of the REWAC Registry. J Invasive Cardiol 2013 [acceso: 23/09/2020]; 25(8): 391-396. Disponible en: https://www.hmpgloballearningnetwork.com/site/jic/articles/long-term-clinical-performance-paclitaxel-eluting-stents-coated-bioactive-polymer-p-5-conta
18. Resúmenes de Trabajos Libres XV Congreso Nacional de Cardiología. Rev. Mex. Cardiol. 2012 [acceso: 23/09/2020]; 23(4): 169-230. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0188-21982012000400001&lng=es
19. Núñez-Gil IJ, Vedia Ó, Pérez-Vizcayno MJ, Mejía-Rentería H, Salinas y P, Fernández-Ortiz A. Reestenosis del stent tras una intervención coronaria percutánea primaria: patrón focal frente a difuso. Influencia del perfil clínico y del tipo de stent. REC Interv Cardiol. 2020 [acceso: 23/09/2020]; 1: 64-7. Disponible en: https://www.recintervcardiol.org/es/?option=com_content&view=arti-cle&id=254&catid=21
20. Lakovou I, Schmidt T, Ge L, Sangiorgi GM, Stankovic G, Airoldi F, et al. Angiographic patterns of restenosis after paclitaxel-eluting stent implantation. Journal of the American College of Cardiology. 2005 [acceso: 23/09/2020]; 45(5):805-6. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0735109704024118
21. Byrne R, Iijima R, Mehilli J, Pache J, Schulz S, Schömig A, et al. Tratamiento de la reestenosis de stents liberadores de paclitaxel mediante implantación de stents liberadores de sirolimus. Resultados angiográficos y clínicos. Revista Española de Cardiología. 2008 [acceso: 23/09/2020]; 61(11): 1134-9. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/S0300893208751637
Published
2021-12-30
How to Cite
1.
Aroche Aportela R, Naranjo-Dominguez A, Rodríguez Navarro Ángel Y, Candeaux Martínez A, Miguel Vázquez Y, Obregón Santos Ángel G. Paclitaxel eluting stents versus bare metal stents restenosis. Rev Cubana Med Milit [Internet]. 2021 Dec. 30 [cited 2025 Apr. 3];51(1):e02201540. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/1540
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