| Objective: This study compared the clinical efficacy and safety of homemade biodegradable polymer sirolimus-eluting stent (EXCELTM) and durable polymer sirolimus-eluting stent (FIREBIRD TM) in treating diffuse coronary lesions.Methods: Between June 2008 and August 2009, total 99 patients of coronary heart disease were enrolled in this study. Diffuse coronary lesion was defined as length of lesion≧2 4mm, which were treated with long (≧ 28mm) EXCELTM stent (The EXCELTM stent-group, EX-S Group) or FIREBIRD TM stent (The FirebirdTM stent-group, FB-S Group).Exclusion criteria: 1) acute myocardial infarction 2) cardiac dysfunction (≧NYHA class III) 3) left main disease 4) in-stent restenosis. All patients after percutaneous coronary intervention(PCI) were performed after 1-month, 3month, 6month, 9month and 12month clinical follow-up, the major adverse cardiovascular events (MACE) including recurrent angina, cardiac death, myocardial infarction, coronary artery bypass graft, target lesion revascularization. Some patients were reviewed with coronary angiography.Results: The EXCELTM stent-group ( EX-S Group) including 51 cases, the FIREBIEDTM stent-group (FB-S Group) including 48 cases, 153 de novo diffused coronary lesions were stented. The main baseline clinical data including smoking, age, gender, diabetes, hypertension, hyperlipidemia, left ventricular ejection fraction were similar between 2 groups. There were no statistic difference in angiographic characteristics of lesions between 2 groups, including:1) Lesions distribution in EX-S Group vs. FB-S Group [(LAD 54.9%vs.57.1%, P=0.731, LXc 27.4% vs.24.1%, P=0.967,RCA 17.6% vs.14.5% P=0.679 ]. 2) The mean stenosis and minimal lumen diameter of the target vessels before PCI in EX-S Group vs. FB-S Group [(82.9±7.6% vs.84.1±7.8%, P=0.564, 0.54±0.21mm vs.0.46±0.23mm, P=0.487)]. 3) The mean length of the target lesions in EX-S Group vs. FB-S Group [(58.8±26.4mm vs.56.3±23.9mm P=0.608)]. 4) The residual stenosis and minimal lumen diameter of the target vessels after PCI in EX-S Group vs. FB-S Group [(12.1±6.4% vs.14.3±5.2%, P=0.785, 3.05±0.40mm vs. 2.97±0.31mm, P=0.647)]. 5) Early gain in EX-S Group vs. FB-S Group [(2.34±0.28 mm vs. 2.41±0.31mm, P=0.674)]. 6) The mean length of stents and number of stents implanted in EX-S Group vs. FB-S Group [(60.5±26.3mm vs.58.2±23.9mm P==0.651, 1.9±0.72vs.2.0±0.72 P=0.428)]. 7)The percentage of overlaped stents implanted in EX-S Group vs. FB-S Group is 66.7% vs 72.9%(P=0.655). Comparing with the incidence of the MACE incidence between 2 groups, there were no statistic difference during 12-month clinical follow-up, but patients in EXCELTM stent group showed less MACE trend (target lesion revascularization) than that of FIREBIRD TM stent group(6.25% vs 3.92%,P>0.05).Conclusion: Both biodegradable polymer sirolimus-eluting stent and durable polymer sirolimus-eluting stent were safe and reliable in treating diffuse coronary lesions. Compared with bioabsorbable sirolimus-eluting stents, we found that durable sirolimus-eluting stents were associated with slightly increased MACE trend during 12-month clinical follow-up. |
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