A more-Comers populAtion trEated with an ultrathin struts polimer-free Sirolimus stent: an Italian post-maRketing study (the CAESAR registry)

• Published in: Frontiers in Cardiovascular Medicine
• Main Authors: Giuseppe Tarantini, Francesco Cardaioli, Giuseppe De Iaco, Bernardino Tuccillo, Maria Carmen De Angelis, Ciro Mauro, Marco Boccalatte, Antonio Trivisonno, Flavio Ribichini, Giuseppe Vadalà, Giuseppe Caramanno, Marco Caruso, Mario Lombardi, Dionigi Fischetti, Alessandro Danesi, Leonardo Abbracciavento, Giulia Lorenzoni, Dario Gregori, Andrea Panza, Luca Nai Fovino, Giovanni Esposito
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2024-01-01
• Subjects: coronary artery disease; PCI; ultrathin struts; acute coronary syndrome (ACS); drug-eluting stent (DES)
• Online Access: https://www.frontiersin.org/articles/10.3389/fcvm.2023.1326091/full

IntroductionThe use of contemporary drug-eluting stents (DES) has significantly improved outcomes of patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). However, concerns exist regarding the long-term proinflammatory effects of durable polymer coatings used in most DES, potentially leading to long-term adverse events. First-generation polymer-free stent technologies, such as sirolimus- and probucol-eluting stents (PF-SES), have shown an excellent safety and efficacy profile. The aim of this study was to evaluate the safety and efficacy of the new ultrathin Coroflex ISAR NEO PF-SES, in a more-comers PCI population.MethodsThe CAESAR (a more-Comers populAtion trEated with an ultrathin struts polimer-free Sirolimus stent: An Italian post-maRketing study) registry is a multicenter, prospective study conducted in Italy, enrolling more-comers CAD patients undergoing PCI with the Coroflex ISAR NEO stent. Patients with left main (LM) disease, cardiogenic shock (CS), or severely reduced left-ventricular ejection fraction (LVEF) were excluded. The primary endpoint was target-lesion revascularization (TLR) at 1 year.ResultsA total of 425 patients were enrolled at 13 centers (mean age 66.9 ± 11.6 years, Diabetes mellitus 29%, acute coronary syndrome 67%, chronic total occlusion 9%). Of these, 40.9% had multivessel disease (MVD) and in 3.3% cases, the target lesion was in-stent restenosis (ISR). Clinical device success was reached in 422 (99.6%) cases. At 1 year, only two (0.5%) subjects presented ischemia-driven TLR. The 1-year rates of target vessel revascularization and MACE were 0.5% and 5.1%, respectively. Major bleeding was observed in four (1.0%) patients.ConclusionIn this multicenter, prospective registry, the use of a new ultrathin Coroflex ISAR NEO PF-SES in a more-comers PCI population showed good safety and efficacy at 1 year.