Stenting of Complex Lesions

“Patients with complex lesions are no longer the exception, they´re actually the majority . . . [Now] XIENCE is a solution for complex intervention.”

 Chuck Simonton, MD, Abbott Vascular Chief Medical Officer 

Increasingly Complex Patients Now Treated with PCI

Complex lesions and increasingly complex percutaneous coronary intervention (PCI) 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

Given the best in class deliverability and the expanded treatment options of XIENCE Sierra, XIENCE becomes the excellent choice for these complex patients.

“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 patients9

XIENCE Complex Patient Data: Consistently Low Stent Thrombosis Rates5-10

Results from a number of multicenter, randomized trials reveal the efficacy and safety of XIENCE, particularly regarding low stent thrombosis (ST) rates, from 30 days to 5 years.

XIENCE Stent Thrombosis Rates

XIENCE Stent Thrombosis Rates

In fact XIENCE Sierra offers best-in-class deliverability and is designed to treat even the most challenging lesions.

* DAPT Duration of 1 month.

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† Bench test data shows that XIENCE Sierra performed better in crossability and was not statistically different in trackability and pushability compared to Resolute Onyx and SYNERGY stents. Bench test results may not necessarily be indicative of clinical performance. Test performed by and data on file at Abbott. Testing performed on XIENCE Sierra Everolimus Eluting Coronary Stent System (3.0 x 18 mm) n=5, SYNERGY Stent System (3.0 x 20 mm) n=5, Resolute Onyx Stent System (3.0 x 18 mm) n=5. Catheter performance crossability test measures average force to cross a challenging lesion model.

‡ Increased maximum expansion compared to other XIENCE Everolimus Eluting Coronary Stent System.

  1. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010;87:4-14
  2. Fefer P, Knudtson ML, Cheema AN, Galbraith PD, Osherov AB, Yalonetsky S, et al. Current perspectives on coronary chronic total occlusions: the Canadian Multicenter Chronic Total Occlusions Registry. J Am Coll Cardiol. 2012;59(11):991–997.
  3. Urban P, et al. Defining high bleeding risk for patients undergoing PCI: A consensus from the Academic Research Consortium. Euro PCR 2019.
  4. Smith SC, et al. Circulation. 2002;105:e165-e169.
  5. Stone, G. “EXCEL: A Prospective, Randomized Trial Comparing Everolimus-Eluting Stents and Bypass Graft Surgery in Selected Patients with Left Main Coronary Artery Disease.” Presented at TCT 2018.
  6. Teeuwen, K. et al. “Hybrid Sirolimus-eluting Stents with Biodegradable Polymer versus Everolimus eluting Stents with Durable Polymer in Chronic Total Occlusions (PRISON IV).” JACC Cardiovasc Interv. 2017; Jan 23; 10(2): 133-143. DOI:10.1016/j.jcin.2016.10.017.
  7. Lam, M. Three year clinical outcome of patients with bifurcation treatment with second-generation Resolute and XIENCE V stents in the randomized TWENTE Trial. American Heart Journal. Vol 169: No 1, Jan 2015.
  8. U Kaul. Paclitaxel-eluting stents versus everolimus-eluting coronary stents in a diabetic
    population: two-year follow-up of the TUXEDO-India trial
    . EuroIntervention 2017: 13:1194-1201
  9. Sabaté M, et al. EXAMINATION Trial. Lancet. 2016;387;357-366.
  10. Watanable, H. et al. One-Month Dual Antiplatelet Therapy Followed by Clopidogrel Monotherapy versus Standard 12-Month Dual Antiplatelet Therapy with Clopidogrel after Drug-Eluting Stent Implantation. STOPDAPT2 Trial.  JAMA. 2019;321(24):2414-2427. doi:10.1001/jama.2019.8145

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