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Ultra-thin (60 m), Ultra-long (≥40 mm) Sirolimus Eluting Stent - Study of clinical and safety profile among real-world patients [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-40909 | DOI: 10.14744/AnatolJCardiol.2020.40909  

Ultra-thin (60 m), Ultra-long (≥40 mm) Sirolimus Eluting Stent - Study of clinical and safety profile among real-world patients

Santosh Kumar Sinha1, Puneet Aggarwal2, Umeshwar Pandey1, Mahmodullah Razi1, Awdesh Kumar1, Vinay Krishna1
1Department of Cardiology, LPS Institute of Cardiology, Kanpur, India
2RML Institute of Cardiology, New Delhi

Background- Though drug-eluting stents (DES) with thinner struts and more flexible design are available, there is paucity of data on ultra-long DES (≥40 mm) use for long coronary lesions. Thus, present study was designed to evaluate safety and effectiveness of an ultra-long (≥40 mm) and ultra-thin (60 m) biodegradable polymer-coated sirolimus-eluting stent (SES)- Supralimus Grace with a unique Long Dual Z (LDZ) link design (Sahajanand Medical Technologies Pvt. Ltd., Surat, India) in real-world patients with long coronary lesions.
Method- Total of 684 patients received assigned stent. Primary outcome was target lesion failure (TLF)-composite of cardiovascular death, target vessel myocardial infarction (MI), and target lesion revascularization (TLR) and peri-procedural secondary end points including device failure (failure of stent delivery, change of stent, stent fracture), patient oriented composite end point (POCE)- composite of all deaths, any MI, and any revascularization and stent thrombosis (ST) were evaluated at one-year follow-up and during procedure.
Result- Mean age of patients included was 52.7 15.9 years and 537 (78.5%) were male. Total 626 (91.5%) patients presented with acute coronary syndrome and 58 (8.5%) patients with chronic coronary syndrome. Total of 989 lesions were treated. Mean number of lesion and stent implanted per patient were 1.3 0.2 mm and 1.4 0.3 mm, respectively. TLF occurred in 42 (6.1%) which was contributed by cardiac death, target vessel MI and TLR in 9(1.3%), 20(2.9%) and 13(1.9%) patients, respectively. POCE was observed in 131 (19.1%) at one-year follow-up mainly contributed by any revascularization 63(9.2%). Stent failure was seen in 21(3.1%) patients as a result of failure of delivery (2.2%), edge dissection (0.8%), and fracture (0.1%). Definite and probable ST was observed in 8(1.1%) and 9(1.3%) patients, respectively.
Conclusion- Ultra-long (≥40mm), ultra-thin (60 m) Supralimus Grace SES can be safely implanted in vessels having long and multiple lesions.

Keywords: Ultra-thin stent, Ultra-long stent, Target lesion revascularization, Stent thrombosis, Percutaneous coronary intervention

Corresponding Author: Santosh Kumar Sinha, India

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