ISSN 2149-2263 | E-ISSN 2149-2271
Volume : 25 Issue : 2 Year : 2021
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The Anatolian Journal of Cardiology Ultrathin (60 μm), ultralong (≥40 mm) sirolimus-eluting stent: study of clinical and safety profiles among real-world patients [Anatol J Cardiol]
Anatol J Cardiol. 2021; 25(2): 111-119 | DOI: 10.14744/AnatolJCardiol.2020.40909

Ultrathin (60 μm), ultralong (≥40 mm) sirolimus-eluting stent: study of clinical and safety profiles 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
2Department of Cardiology, Dr. Ram Manohar Lohia Institute of Cardiology; New Delhi-India

Objective: Although thin-strut drug-eluting stents (DES) with a more flexible design are easily obtainable, data regarding using ultralong DES (≥40 mm) for long coronary lesions are limited in the literature. Therefore, the current study assessed the safety and efficacy of an ultralong (≥40 mm) and ultrathin (60 μm) biodegradable polymer-coated sirolimus-eluting stent (SES), Supralimus Grace, with a unique Long Dual Z-link (LDZ-link) design (Sahajanand Medical Technologies Pvt. Ltd., Surat, India) in real-world patients with long coronary lesions.

Methods: The assigned stents were implanted in 684 patients. The primary endpoint was target lesion failure (TLF), which is a composite of cardiovascular death, target vessel myocardial infarction (MI), and target lesion revascularization (TLR), whereas periprocedural secondary endpoints included device failure (failure of stent delivery, change of stent, and stent fracture) and patient-oriented composite endpoint (POCE), which is a composite of all deaths, any MI, and any revascularization, and stent thrombosis (ST). These outcomes were analyzed at one-year follow-up and during the procedure.

Results: The patients’ mean age was 52.7±15.9 years; 537 (78.5%) were males. 626 (91.5%) patients suffered from acute coronary syndrome and 58 (8.5%) patients from chronic coronary syndrome (CSS). 989 lesions were removed. The mean numbers of lesions and stents implanted per patient were 1.3±0.2 mm and 1.4±0.3 mm, respectively. TLF occurred in 42 (6.1%) as a result of 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 patients (19.1%) at one-year follow-up, mainly in 63 (9.2%) patients because of any revascularization. Stent failure was seen in 21 patients (3.1%) as a result of delivery failure (2.2%), edge dissection (0.8%), and fracture (0.1%). Definite and probable ST were observed in 8 (1.1%) and 9 (1.3%) patients, respectively.

Conclusion: Ultralong (≥40 mm), ultrathin (60 μm) Supralimus Grace stent can be safely implanted in vessels having long and multiple lesions.

Keywords: drug-eluting stent, ultrathin stent, ultralong stent, target lesion failure, stent thrombosis, percutaneous coronary intervention, target lesion revascularization

Santosh Kumar Sinha, Puneet Aggarwal, Umeshwar Pandey, Mahmodullah Razi, Awdesh Kumar, Vinay Krishna. Ultrathin (60 μm), ultralong (≥40 mm) sirolimus-eluting stent: study of clinical and safety profiles among real-world patients. Anatol J Cardiol. 2021; 25(2): 111-119

Corresponding Author: Santosh Kumar Sinha, India