Abstract 2774: Six-Month IVUS Analysis of Long Coronary Artery Lesions Treated with Biolimus-A9 Eluting XTENT interdigitating stent with bioabsorbable polymer: Results of the CUSTOM II Trial
Background: Multiple overlapping drug-eluting stents have been used to treat diffuse coronary disease; however, this approach is associated with increased incidence of adverse cardiac events and target lesion revascularization (TLR). The XTENT platform consists of Biolimus-A9 eluting stent on a bioabsorbable polymer with an interdigitating design, which allows operators to customize stent length in 6 mm cobalt-chromium modular units. The aim of this IVUS study was to evaluate the efficacy of the XTENT in the treatment of long lesions.
Methods: Data were obtained from the CUSTOM II trial, a prospective, multicenter study, to assess the safety and efficacy of this stent system. Thirty patients (39 lesions) were available, with 6 months follow-up IVUS analysis, including 25 serial lesions. Lesions were divided into 2 groups: short (<24 mm, n=13) and long (≥ 24 mm, n=12). Volumetric and/or cross-sectional analyses were performed. Each volume index was calculated as volume divided by stent length. Percent neointimal volume (%NIV) was calculated as (neointimal volume/stent volume) X100.
Results: Baseline and 6 months follow-up IVUS data are shown in Table⇓. Despite very long lesions and stent length (34.4±9.5 mm and 42.5±7.7 mm, respectively), % neointimal volume was < 10%, even in the long lesion group. There were no differences in plaque volume index and vessel volume index at 6 months follow-up between the long and short lesion groups. One case with partial separation between the segments was found at follow-up in the long lesion group, but no lumen loss at the separation was observed. There was one TLR case in each group, but no cardiac death, AMI, and late-acquired incomplete stent apposition (ISA) in either group.
Conclusions: The XTENT stent demonstrated excellent suppression of neointimal hyperplasia in long coronary artery lesions at 6 months follow-up. This stent system may offer an option for treatment of complex diffuse lesions.