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Current Cardiology Reviews


ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

Synergy Between Direct Coronary Stenting Technique and Use of the Novel Thin Strut Cobalt Chromium Skylor™ Stent: the Mace in Follow Up Patients Treated with Skylor Stent [MILES Study]

Author(s): Arturo Giordano, Michele Polimeno, Nicola Corcione, Luciano Fattore, Luigi Di Lorenzo, Giuseppe Biondi-Zoccai, Paolo Ferraro and Maria Fiammetta Romano

Volume 8 , Issue 1 , 2012

Page: [6 - 13] Pages: 8

DOI: 10.2174/157340312801215818

Price: $65


BACKGROUND: Despite significant improvements in stent platform, currently available bare-metal stents (BMS) are still associated with restenosis. Thin-strut design cobalt-chromium alloys hold the promise of improving results of BMS, especially when implanted with direct technique. We performed an observational study to appraise outcomes of the novel Skylor™ stent, stratifying outcomes according to stenting technique.

METHODS and RESULTS: We included all consecutive patients undergoing coronary stenting with Skylor™ at 2 centers between 2006 and 2009. The primary end-point was the long-term rate of major adverse cardiac events (MACE, i.e. death, myocardial infarction (MI), coronary artery bypass grafting (CABG) or target vessel revascularization (TVR)). As pre-specified analysis, we compared patients undergoing direct stenting versus those stent implantation following predilation. A total of 1020 patients were included (1292 Skylor™ stents), with procedural success obtained in 99%. Comparing patients undergoing direct stenting (66%) versus pre-dilation (34%) at 16±7 months of follow-up, MACE had occurred in, respectively, 8% versus 14% (p=0.001), with death in 1% versus 2% (p=0.380), MI in 1% versus 2% (p=0.032), CABG in 0.2% versus 2% (p=0.012), and TVR in 6% versus 9% [p=0.071]. Even at multivariable analysis with propensity adjustment, direct stenting was associated with significantly fewer MACE [hazard ratio 0.60 [0.38-0.93], p=0.024].

CONCLUSIONS: This observational study suggests the presence of a beneficial synergy between direct coronary stenting technique and use of the novel thin-strut cobalt-chromium Skylor™ stent in real-world patients undergoing PCI.

Keywords: Angioplasty, stents, restenosis, MILES, PCI centers, DES, SPSS-PASW, soenzyme, CABG

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