Advertisement

Cardiovascular Intervention and Therapeutics

, Volume 33, Issue 4, pp 321–327 | Cite as

Efficacy of biolimus A9-eluting stent for treatment of right coronary ostial lesion with intravascular ultrasound guidance: a multi-center registry

  • Kenya Nasu
  • Yuji Oikawa
  • Maoto Habara
  • Shinichi Shirai
  • Hidetoshi Abe
  • Makoto Kadotani
  • Ryo Gotoh
  • Hidenari Hozawa
  • Hiroshi Ota
  • Takashi Suzuki
  • Yoshihisa Shibata
  • Masaki Tanabe
  • Yuya Nakagawa
  • Takeshi Serikawa
  • Shiro Nagasaka
  • Yasuyo Takeuchi
  • Yoshihide Fujimoto
  • Hiroshi Tamura
  • Yuichi Kobori
  • Junji Yajima
  • Tadanori Aizawa
  • Takahiko Suzuki
  • On behalf of NO-RECOIL Registries Investigators
Original Article
  • 120 Downloads

Abstract

The aim of this study was to assess the efficacy of a biolimus A9-eluting stent in patients with a right coronary artery (RCA) ostial lesion. Ostial lesions of the RCA have been a limitation of percutaneous coronary intervention even in the drug-eluting stent (DES) era. However, clinical outcomes after the deployment of a second generation DES to an RCA ostial lesion with intravascular ultrasound (IVUS) guidance have not been fully elucidated. From September 2011 to March 2013, 74 patients were enrolled in 17 centers from Japan. RCA ostial lesion was defined as de novo significant stenotic lesion located within 15 mm from ostium. IVUS was used for all cases to confirm the location of ostium and evaluate stent coverage of ostium. Patients with hemodialysis were excluded. The primary endpoint is a major adverse cardiac event (MACE) at 1 year. Forty two percent of patients had multi-vessel disease. Angiographically severe calcification was observed in 26% of the lesions. The mean stent diameter was 3.3 ± 0.3 mm (3.5 mm, 72%, 3.0 mm, 25%, and 2.75 and 2.5 mm, 3%), stent length was 17.5 ± 5.8 mm, and dilatation pressure of stenting was 15.6 ± 4.1 atm. RCA ostium was covered by stent in all lesions in IVUS findings. Post dilatation was performed for 64% of lesions (balloon size 3.7 ± 0.6 mm). MACE rate at 1 year was 5.4% (target lesion revascularization 5.4%, myocardial infarction 1.2%, and no cardiac death). The biolimus A9-eluting stent for RCA ostial lesions with IVUS guidance showed favorable results at 1-year follow-up.

Keywords

Right coronary artery Ostial lesion Intravascular ultrasound guidance Biolimus A9-eluting stent 

References

  1. 1.
    Topol EJ, Ellis SG, Fishman J, Leimgruber P, Myler RK, Stertzer SH, et al. Multicenter study of percutaneous transluminal angi-oplasty for right coronary artery ostial stenosis. J Am Coll Cardiol. 1987;9:1214–8.CrossRefGoogle Scholar
  2. 2.
    Hoffmann R, Mintz GS, Mehran R, Pichard AD, Kent KM, Satler LF, et al. Intravascular ultrasound predictors of angiographic restenosis in lesions treated with Palmaz–Schatz stents. J Am Coll Cardiol. 1998;31:43–9.CrossRefGoogle Scholar
  3. 3.
    Popma JJ, Brogan WC 3rd, Pichard AD, Satler LF, Kent KM, Mintz GS, et al. Rotational coronary atherectomy of ostial stenoses. Am J Cardiol. 1993;71:436–8.CrossRefGoogle Scholar
  4. 4.
    Eigler NL, Weinstock B, Douglas JS Jr, Goldenberg T, Hartzler G, Holmes D, et al. Excimer laser coronary angioplasty of aorto-ostial stenoses. Results of the excimer laser coronary angioplasty(ELCA) registry in the first 200 patients. Circulation. 1993;88:2049–57.CrossRefGoogle Scholar
  5. 5.
    Zampieri P, Colombo A, Almagor Y, Maiello L, Finci L. Results of coronary stenting of ostial lesions. Am J Cardiol. 1994;73:901–3.CrossRefGoogle Scholar
  6. 6.
    Kurbaan AS, Kelly PA, Sigwart U. Cutting balloon angioplasty and stenting for aorto-ostial lesions. Heart. 1997;77:350–2.CrossRefGoogle Scholar
  7. 7.
    Jain SP, Liu MW, Dean LS, Babu R, Goods CM, Yadav JS, et al. Comparison of balloon angioplasty versus debulking devices versus stenting in right coronary ostial lesions. Am J Cardiol. 1997;79:1334–8.CrossRefGoogle Scholar
  8. 8.
    Kotani J, Ikari Y, Kyo E, Nakamura M, Yokoi H, Furuno K, et al. Five-year outcomes of Cypher™ coronary stent: report from J-PMS Study. Cardiovasc Interv Ther. 2012;27(2):63–71 Epub 2012 Jan 17.CrossRefGoogle Scholar
  9. 9.
    Kyono H, Kozuma K, Shiratori Y, Maeno Y, Iino R, Takada K, et al. Angiographic and clinical outcomes of 100 consecutive severe calcified lesions requiring rotational atherectomy prior to sirolimus-eluting stent implantation in hemodialysis and non-hemodialysis patients. Cardiovasc Interv Ther. 2011;26(2):98–103.CrossRefGoogle Scholar
  10. 10.
    Morice MC, Serruys PW, Sousa JE, Fajadet J, Ban Hayashi E, Perin M, et al. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002;346:1773–80.CrossRefGoogle Scholar
  11. 11.
    Sakamoto H, Ishikawa T, Mutoh M, Imai K, Mochizuki S. Angiographic and clinical outcomes after sirolimus-eluting stent implantation to de novo ostial lesion of the right coronary artery: a retrospective study. Circ J. 2008;72:880–5.CrossRefGoogle Scholar
  12. 12.
    Luz A, Hughes C, Magalhães R, Bisceglia T, Descoutures F, Tamamm K, Tchetche D, Sauguet A, Farah B, Fajadet J. Stent implantation in aorto-ostial lesions: long-term follow-up and predictors of outcome. EuroIntervention. 2012;7:1069–76.CrossRefGoogle Scholar
  13. 13.
    Rensing BJ, Hermans WR, Strauss BH, Serruys PW. Regional differences in elastic recoil after percutaneous transluminal coronary angioplasty: a quantitative angiographic study. J Am Coll Cardiol. 1991;17:34B–8B.CrossRefGoogle Scholar
  14. 14.
    Ota T, Ishii H, Sumi T, et al. Impact of coronary stent designs on acute stent recoil. J Cardiol. 2014;64:347–52.CrossRefGoogle Scholar
  15. 15.
    Fujii K, Carlier SG, Mintz GS, Yang YM, Moussa I, Weisz G, et al. Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study. J Am Coll Cardiol. 2005;45:995–8.CrossRefGoogle Scholar
  16. 16.
    Cutlip DE, Windecker S, Mehran R, et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation. 2007;115:2344–51.CrossRefGoogle Scholar
  17. 17.
    Ko E, Natsuaki M, Toyofuku M, et al. Sirolimus-eluting implantation for ostial right coronary artery lesions: five-year outcomes from the j-Cypher registory. Cardiovasc interv and Ther. 2014;29:200–8.CrossRefGoogle Scholar
  18. 18.
    Stewart JT, Ward DE, Davies MJ, Pepper JR. Isolated coronary ostial stenosis: observations on the pathology. Eur Heart J. 1987;8:917–20.CrossRefGoogle Scholar
  19. 19.
    Popma JJ, Dick RJ, Haudenschild CC, Topol EJ, Ellis SG. Atherectomy of right coronary ostial stenoses: initial and long-term results, technical features and histologic findings. Am J Cardiol. 1991;67:431–3.CrossRefGoogle Scholar
  20. 20.
    Takebayashi H, Mintz GS, Carlier SG, Kobayashi Y, Fujii K, Yasuda T, et al. Non-uniform strut distribution correlates with more neointimal hyperplasia after sirolimus-eluting stent implantation. Circulation. 2004;110:3430–4.CrossRefGoogle Scholar
  21. 21.
    Boucek RJ, Takeshita R, Brady AH. Microanatomy and intra-mural physical forces within the coronary arteries (man). Anat Rec. 1965;153:233–41.CrossRefGoogle Scholar
  22. 22.
    Williams PD, Appleby CE, Chowdhary S, et al. A method for treating acute stent recoil and luminal filling defects. Eurointervention. 2011;6:846–53.CrossRefGoogle Scholar
  23. 23.
    Lam MK, Sen H, Tandjung K, et al. Clinical outcome of patients with implantation of second-generation drug-eluting stents in the right coronary ostium: insights from 2-year follow-up of the TWENTE trial. Catheter Cardiovasc Interv. 2015;85:524–31.CrossRefGoogle Scholar
  24. 24.
    Iakovou I, Ge L, Michev I, et al. Clinical and angiographic outcome after sirolimus-eluting stent implantation in aorto-ostial lesions. J Am Coll Cardiol. 2004;44:967–71.CrossRefGoogle Scholar

Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2017

Authors and Affiliations

  • Kenya Nasu
    • 1
  • Yuji Oikawa
    • 2
  • Maoto Habara
    • 1
  • Shinichi Shirai
    • 3
  • Hidetoshi Abe
    • 4
  • Makoto Kadotani
    • 5
  • Ryo Gotoh
    • 6
  • Hidenari Hozawa
    • 7
  • Hiroshi Ota
    • 8
  • Takashi Suzuki
    • 9
  • Yoshihisa Shibata
    • 10
  • Masaki Tanabe
    • 11
  • Yuya Nakagawa
    • 12
  • Takeshi Serikawa
    • 13
  • Shiro Nagasaka
    • 14
  • Yasuyo Takeuchi
    • 14
  • Yoshihide Fujimoto
    • 15
  • Hiroshi Tamura
    • 16
  • Yuichi Kobori
    • 17
  • Junji Yajima
    • 2
  • Tadanori Aizawa
    • 2
  • Takahiko Suzuki
    • 1
  • On behalf of NO-RECOIL Registries Investigators
  1. 1.Department of CardiologyToyohashi Heart CenterToyohashiJapan
  2. 2.Department of CardiologyThe Cardiovascular InstituteTokyoJapan
  3. 3.Department of CardiologyKokura Memorial HospitalKitakyushuJapan
  4. 4.Cardiovascular CenterMatsumoto Kyoritsu HospitalMatsumotoJapan
  5. 5.Department of CardiologyKakogawa East City HospitalKakogawaJapan
  6. 6.Division of CardiologyShuwa General HospitalSaitamaJapan
  7. 7.Department of Cardiovascular MedicineNewheart Watanabe InstituteTokyoJapan
  8. 8.Department of CardiologyItabashi Chuo Medical CenterTokyoJapan
  9. 9.Cardiovascular CenterKin-ikyo Central HospitalSapporoJapan
  10. 10.Department of CardiologyJapanese Red Cross Nagoya Daiichi HospitalNagoyaJapan
  11. 11.Department of CardiologyDaini Okamoto General HospitalUjiJapan
  12. 12.Department of CardiologyTokyo-Kita Social Insurance HospitalTokyoJapan
  13. 13.Division of CardiologySaiseikai Fukuoka General HospitalFukuokaJapan
  14. 14.Department of CardiologySeirei Mikatahara General HospitalHamamatsuJapan
  15. 15.Department of CardiologyKimitsu Chuo HospitalKisarazuJapan
  16. 16.Department of CardiologyJuntendo University Shizuoka HospitalIzunokuniJapan
  17. 17.Department of CardiologyToda Chuo General HospitalTodaJapan

Personalised recommendations