Short-term clinical analysis of the use of Endeavor stent vs bare metal stents in primary PCI

Background: Bare metal stents (BMS) are a reasonable option even in the modern era of superior outcomes with 2nd generation drug eluting stents mainly because of the need for short term dual antiplatelet platelet therapy (DAPT). Current guidelines recommend a minimum of 1 month of DAPT following BMS use. The safety of limiting DAPT to one month has not been clearly established. Methods: We searched PubMed, Scopus and ClinicalTrials.gov databases till May 2014 for randomized clinical trials (RCTs) that compared short (<6 months) versus long DAPT duration (> 6 months) after BMS. Risks ratios (RRs) with 95% confidence interval (CI) for the composite outcome of cardiac death or myocardial infarction (MI) and for major bleeding were calculated using random-effects model. Results: We included 3 RCTs in this analysis. A total of 2654 patients received short term DAPT and 2612 patients received long term DAPT (9 to 24 months). The rates of cardiac death or MI were significantly higher in the short-term DAPT group (9.1%) compared to the prolonged DAPT group (7.0%)which corresponds to a 30% increase in the risk of cardiac death or MI (RR: 1.30, 95% CI: 1.08 to 1.57; p=0.005, figure). On the other hand, short-term DAPT was associated with numerically lower major bleeding events (4.0% vs 5.0%) when compared with prolonged DAPT but this did not reach statistical significance (p=0.06). Conclusion: Short-term DAPT as compared with prolonged treatment is associated with an increased risk of cardiac death or MI.

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Paclitaxel-eluting versus bare metal stents in primary PCI: a pooled patient-level meta-analysis of randomized trials

Journal of Thrombosis and Thrombolysis ◽

10.1007/s11239-014-1091-4 ◽

2014 ◽

Vol 39 (1) ◽

pp. 101-112 ◽

Cited By ~ 3

Author(s):

Giuseppe De Luca ◽

Maurits T. Dirksen ◽

Henning Kelbæk ◽

Leif Thuesen ◽

Marteen A. Vink ◽

...

Keyword(s):

Randomized Trials ◽

Meta Analysis ◽

Bare Metal Stents ◽

Metal Stents ◽

Bare Metal ◽

Primary Pci ◽

Patient Level

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Abstract 3438: Comparison of Endothelial Progenitor Cell Capture Stent with Bare Metal Stent In Patients Undergoing Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction

Circulation ◽

10.1161/circ.116.suppl_16.ii_777-a ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Tay Lik-Wui Edgar ◽

Chua Melissa-Co ◽

Lee Chi-Hang ◽

Low Adrian ◽

Lim Jimmy ◽

...

Keyword(s):

Myocardial Infarction ◽

Endothelial Progenitor Cell ◽

Progenitor Cell ◽

Bare Metal Stents ◽

Bare Metal Stent ◽

Metal Stents ◽

Bare Metal ◽

Primary Pci ◽

Metal Stent ◽

The Mean

Background: The endothelial progenitor cell (EPC) capture bio-engineered stent (Genous ® stent, OrbusNeich) was designed to attract circulating EPCs and promote rapid endothelization. The aim of this study was to compare clinical outcomes between patients with ST-segment elevation myocardial infarction (STEMI) who received this stent versus those who received Liberte (Boston Scientific) bare metal stents. Methodology: Three hundred and forty two patients who presented to our centers with STEMI without cardiogenic shock and underwent primary PCI with either EPC Capture-or bare metal stent implantation were enrolled in this study. All patients received dual anti-platelet therapy for a month; and statin therapy was initiated soon after PCI. The study endpoints were major adverse cardiac events (MACE) at 30 days, 6 months and 1 year. Results: A total of 164 EPC Capture stents and 178 BMS were implanted. Baseline patient characteristics were comparable in the 2 groups. The mean lesion length in the 2 groups were 20.4.0 ± 5.1 and 22.8 ± 7.6mm, and the mean reference vessel diameter 3.14 ± 0.65 and 2.70 ± 1.14 mm respectively. At 6 months, the results were: Conclusion: There was no significant difference in MACE at 6 month between EPC Capture-and bare metal stents in patients with STEMI who underwent primary PCI. The 1-year data will be presented at the meeting.

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Faculty Opinions recommendation of A prospective randomized trial of everolimus-eluting stents versus bare-metal stents in octogenarians: the XIMA Trial (Xience or Vision Stents for the Management of Angina in the Elderly).

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718173332.793488348 ◽

2013 ◽

Author(s):

Claudia Martinez

Keyword(s):

Randomized Trial ◽

Bare Metal Stents ◽

The Elderly ◽

Prospective Randomized Trial ◽

Metal Stents ◽

Bare Metal

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Faculty Opinions recommendation of Drug-Eluting or Bare-Metal Stents for Coronary Artery Disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726696134.793524354 ◽

2016 ◽

Author(s):

Wilbert Aronow

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Bare Metal Stents ◽

Metal Stents ◽

Bare Metal ◽

Drug Eluting ◽

Artery Disease

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Transbrachial and transfemoral approaches combined with visceral protection for the treatment of juxtarenal aortoiliac occlusive disease: Technical issues and clinical outcomes

Vascular ◽

10.1177/17085381211023229 ◽

2021 ◽

pp. 170853812110232

Author(s):

Peixian Gao ◽

Changliang Li ◽

Xuejun Wu ◽

Gang Li ◽

Dianning Dong ◽

...

Keyword(s):

Endovascular Treatment ◽

Bare Metal Stents ◽

Covered Stent ◽

Occlusive Disease ◽

Metal Stents ◽

Infrarenal Aorta ◽

Bare Metal ◽

Stent Grafts ◽

Aortoiliac Occlusive Disease

Purpose To evaluate the safety and efficacy of transbrachial and transfemoral approaches combined with visceral protection for the endovascular treatment of juxtarenal aortoiliac occlusive disease (AIOD) over an average 19-month follow-up period. Methods In this retrospective analysis, all patients with juxtarenal AIOD at a single institution were reviewed from June 2015 to January 2020. Patient characteristics, angiographic results, and follow-up outcomes were retrospectively recorded. The indications for treatment were critical limb threatening ischemia in 12 patients and bilateral claudication in five patients. Percutaneous access via the left brachial artery was first obtained to recanalize the infrarenal occluded lesions. After that, femoral accesses were achieved. A 4-Fr catheter, a 4 mm balloon, or a 6-Fr 90-cm-long sheath was used to complete visceral artery protection. Results A total of 17 juxtarenal AIOD patients (14 males; mean age, 63.4 ± 8.1 years) underwent endovascular treatment. The technical success rate was 100%. Complete reconstruction was achieved in 15 (88.2%) patients. The infrarenal aorta was reconstructed with kissing covered stent grafts ( n = 7), kissing bare-metal stents ( n = 2), covered stent grafts ( n = 2), bare-metal stents ( n = 1), or the off-label use of iliac limb stent grafts ( n = 5). Renal embolization was found in 3 (17.6%) patients during intraoperative angiography. There was 1 (5.9%) case of distal runoff embolization after CDT and 1 (5.9%) case of left iliac artery rupture. One (5.9%) death occurred due to acute myocardial infarction 20 days after the operation. The average follow-up period was 19.3 ± 16.7 months (range, 1–54 months) in the remaining 16 cases. The renal artery patency rate was 100%. The estimated cumulative primary patency rates were 92.3% at 12 months and 59.3% at 36 months according to the Kaplan–Meier method. Conclusions Transbrachial and transfemoral approaches combined with visceral protection offer a safe and effective alternative to open revascularization for the endovascular treatment of juxtarenal AIOD.

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