Zotarolimus-eluting stent in complex lesions versus non-complex lesions from Japanese all-comers registry

Background Drug-eluting stents (DES) have significantly advanced in 21st century, which enabled percutaneous coronary intervention (PCI) to challenge more complex lesions. It is also known that Japanese PCI operators are relatively familiar with complex PCI. However, its real-world data regarding PCI procedure and its outcome is not sufficient. We aimed to compare clinical outcome between complex lesions and non-complex using all-comers zotarolimus-eluting stent (ZES) registry in Japan. Methods This was an all-comer registry of ZES from 65 institutes in Japan. Complex lesion was defined as chronic total occlusion (CTO), left main disease, bifurcation lesion requiring 2-stent technique, lesions requiring debulking device, number of stents 3 or greater and total length of stents >60mm. Major adverse cardiac events included cardiac death, spontaneous myocardial infarction and target lesion revascularization and followed for 2-years. Patients’ characteristics, procedure characteristics and MACE were compared between complex lesions and non-complex lesions. Results A total of 795 patients including 246 patients with complex lesions and 549 patients with non-complex lesions were finally analyzed. The most frequent reason selected for complex lesions was CTO (35.4%) followed by long stenting (35.4%), need of debulking device (28.9%) and left main disease (10.2%). Intravascular imaging was used in more than 99% of all populations. Cumulative incidence of MACE at 2-years were similar between complex lesions and non-complex lesions. (4.9% versus 3.8%, P=0.49). Conclusion ZES showed decent clinical result in complex lesions and non-complex lesions from Japanese real-world data.