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- 幻灯介绍：
Stenting of Coronary Arteries in Non Stress/Benestent Disease
Presented at
American College of Cardiology
Scientific Sessions 2005
Presented by Dr. Henning Kelb?k
SCANDSTENT Trial
Endpoints (6 months):
Minimum lumen diameter and angiographic restenosis (>50%)
SCANDSTENT Trial
Presented at ACC Scientific Sessions 2005
322 stable angina, unstable angina, or non-ST elevation MI patients with complex lesions (occluded, bifurcational, ostial, or angulated)
Randomized
Sirolimus-eluting Stent (SES)
n=163
Bare Metal Stent (BMS)
n=159
Presented at ACC Scientific Sessions 2005
%
There were no differences by treatment group in the clinical endpoints of death, MI, or stent thrombosis.
Target lesion revascularization was significantly lower in the SES group, and as a result, overall MACE was lower in the SES group.
SES
BMS
Death
p=NS
SCANDSTENT Trial
SES
BMS
SES
BMS
MI
p=NS
Stent Thrombosis
p=NS
SES
BMS
SES
BMS
Target Lesion Revascularization
p<0.001
MACE
p<0.001
Presented at ACC Scientific Sessions 2005
On 6 month angiographic follow-up, minimum lumen diameter was larger in the SES group than BMS group as was late lumen loss.
Both percent diameter stenosis and binary restenosis were lower in the SES group compared with the BMS group.
Minimum Lumen Diameter
p<0.0001
6 Month Angiographic Follow-up
SCANDSTENT Trial
Late Lumen Loss
p<0.0001
% Diameter Stenosis
p<0.0001
Binary
Restenosis
p<0.0001
SES
BMS
SES
BMS
SES
BMS
SES
BMS
Among patients with complex lesions, use of sirolimus-eluting stents was associated with a reduction in target lesion revascularization and improvements in diameter stenosis at 6 month follow-up compared with bare metal stents.
Prior studies such as SIRIUS have shown a similar benefit with sirolimus-eluting stents over bare metal stents in patients with simple de novo lesions. Additionally, a prior study by Colombo, et al reported a benefit in bifurcation lesions. Finally, the TAXUS V trial recently demonstrated a reduction in target vessel revascularization with paclitaxel-eluting stents for a variety of complex coronary lesions.
As with other drug-eluting stent trials, improvements were seen in target lesion revascularization and restenosis but no difference was observed in other clinical events.
Presented at ACC Scientific Sessions 2005
SCANDSTENT Trial: Summary