Stenting of Complex Lesions

“Not all drug-eluting stents are created equal.”

 Sripal Bangalore, MD, noting positive XIENCE outcomes
at TCT 2016 

Increasingly Complex Patients Now Treated with PCI

Complex lesions and increasingly complex cases compose an ever-growing segment of the patient population.

Many complex patients are now able to benefit from minimally invasive procedures like percutaneous coronary intervention (PCI), whereas in previous years stenting of complex lesions may not have been an option. Using XIENCE in many complex patients is associated with low rates of stent thrombosis. Consequently, stenting for complex lesions may in fact expand in the future.

XIENCE for Complex Patients

XIENCE, the world’s leading drug-eluting stent (DES), is considered by industry experts to be the gold standard. It is increasingly used—and evaluated via clinical trials—in complex patients:

  • ST-segment elevation MI (STEMI)
  • Multi-vessel disease
  • Long lesions 
  • Small vessels

“The benefit of [XIENCE] occurred immediately after implantation and . . . also at long-term follow-up beyond 2 years.” 

— Manel Sabaté, MD, on the EXAMINATION trial's lower event rates for XIENCE versus bare metal stents in STEMI patients6 

XIENCE Complex Patient Data: Consistently Low Stent Thrombosis

Results from a number of multicenter, randomized trials reveal the efficacy and safety of XIENCE, particularly regarding low stent thrombosis rates.

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  1. Complex lesions include ACC/AHA Type B2 and C lesions. Krone RJ, et al. Am J Cardiol. 2003;92:389–394.
  2. Karmpaliotis D, et al. Catheter Cardiovasc Interv. 2013;82:1-8. doi: 10.1002/ccd.24387.
  3. Morice M-C, et al. JACC. 2013;61:1122-1123.
  4. Urban P, et al. Am Heart J. 2013;165:704-709. doi: 10.1016/j.ahj.2013.01.008.
  5. Smith SC, et al. Circulation. 2002;105:e165-e169.
  6. Sabaté M, et al. EXAMINATION Trial. Lancet. 2016;387;357-366.
  7. Teeuwen K, et al. PRISON IV Trial. JACC Cardiovasc Interv. 2016. doi: 10.1016/ j.jcin.2016.10.017.
  8. Kaul U. TUXEDO Trial 2-year data. TCT 2016.   
  9. Stone GW, et al. EXCEL Trial. N Engl J Med. 2016;375:2223-2235. doi: 10.1056/NEJMoa1610227.
  10. de Belder A, et al. XIMA Trial. JACC. 2014;63:1371–1375.

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