Key result
The ultra-long 48-mm Xience Xpedition everolimus-eluting stent demonstrated a 7.6% rate of major adverse cardiac events at a median follow-up of 24 months in a real-world population.
Why the study?
Diffuse long coronary lesions are difficult to treat percutaneously, motivating an assessment of the procedural safety and long-term efficacy of the ultra-long (48-mm) Xience Xpedition stent.
Does the ultra-long 48-mm everolimus-eluting stent provide safe and effective outcomes in patients with diffuse long coronary lesions?
Observational (n=92)
No
Does the ultra-long 48-mm everolimus-eluting stent provide safe and effective outcomes in patients with diffuse long coronary lesions?
The deployment of the ultra-long 48-mm everolimus-eluting stent is feasible and safe for diffuse long coronary lesions, with favorable intermediate-term outcomes in patients without cardiogenic shock.
Supports feasibility of ultra-long everolimus-eluting stents in diffuse lesions without shock; leaves open need for randomized confirmation.
Background: Diffuse long coronary lesions are difficult to treat percutaneously. The aim of the present study was to assess the procedural safety and long-term efficacy of the ultra-long (48-mm) drug-eluting stent Xience Xpedition. Methods: This was an investigator-initiated, observational, all-comers study. A total of 92 patients with 93 lesions were enrolled in the study from October 2016 to October 2020. The primary outcome of the study was major adverse cardiac events (MACEs). Secondary outcomes were individual components of the primary outcome and procedural success. Results: The mean (standard deviation (SD)) age of the participants was 58.8 (10.8) years. More than half of the patients had ST-segment elevation myocardial infarction (STEMI) at presentation (55.4%). Ten patients were in cardiogenic shock (CGS; 10.8%). Most of the lesions were located in the left anterior descending artery (48.3%). American College of Cardiology/American Heart Association (ACC/AHA) type C was the most common lesion type amongst the intervened vessels (46.74%), with a mean syntax score (SD) of 16.99 (8.89). The mean stent diameter used was 2.77 mm (0.25). MACE was observed in 7.6% of patients studied at a median follow-up of 24 months. MACE was significantly lower in the population without CGS, occurring in only 2.4% of the patients; a significant difference in MACE was observed in patients with and without CGS (P < 0.001). Procedural success was obtained in 89.2% of total population; however, 96.3% of patients without CGS had procedural success. Conclusions: The deployment of the ultra-long 48-mm Xience Xpedition stent is feasible, safe, and effective; and it was associated with a good intermediate-term clinical outcome.
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Senguttuvan et al. (2022) conducted an observational in Diffuse long coronary lesions (n=92). Xience Xpedition ultra-long everolimus-eluting stent was evaluated on Major adverse cardiac events (MACEs). The ultra-long 48-mm Xience Xpedition everolimus-eluting stent demonstrated a 7.6% rate of major adverse cardiac events at a median follow-up of 24 months in a real-world population.
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