Comparison of sirolimus eluting stent with bioresorbable polymer to everolimus eluting stent with permanent polymer in bifurcation lesions: Results from CENTURY II trial

Catheter Cardiovasc Interv. 2016 May;87(6):1092-100. doi: 10.1002/ccd.26150. Epub 2015 Aug 13.

Abstract

Objective: To demonstrate the safety and efficacy of a new sirolimus eluting stent with bioresorbable polymer, Ultimaster, (BP-SES) compared with everolimus-eluting, permanent polymer, Xience stent (PP-EES) in bifurcation lesions with respect to the freedom from Target Lesion Failure at 1-year.

Methods: Within 1,119 patients enrolled in the CENTURY II randomized controlled multicenter trial, 194 patients were treated for bifurcation lesions and randomized to either BP-SES (n = 95) or PP-EES (n = 99). The primary endpoint was freedom from target lesion failure (TLF) composite endpoint [cardiac death, MI not clearly attributable to a non-target vessel, and clinically driven target lesion revascularization (TLR)] at 1-year.

Results: Baseline patient demographic, angiographic, and stenting characteristics were similar in both study arms. A single stent technique with provisional or "cross over" stenting were the most widely used in both arms (93.2% BP-SES vs. 92.4% PP-EES). Freedom from TLF at 1-year was 94.7% for BP-SES and 91.9% for PP-EES (P for noninferiority 0.031). The rate of clinically driven target lesion revascularization (TLR) at 1-year was 3.2% for BP-SES and 3.0% for PP-EES (P = 0.95). There were no significant differences detected in any of the individual clinical endpoints or other secondary clinical endpoints between the study arms at 1-year follow up.

Conclusions: The new bioresorbable polymer sirolimus-eluting stent showed safety and efficacy profiles similar to durable polymer everolimus-eluting in the treatment of patients with bifurcation lesions at 1-year follow up. © 2015 Wiley Periodicals, Inc.

Keywords: Sirolimus eluting stent; cobalt-chromium stent; complex lesions; coronary bifurcation; drug eluting stent.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Absorbable Implants*
  • Aged
  • Coronary Angiography
  • Coronary Artery Disease
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / surgery
  • Drug-Eluting Stents*
  • Everolimus / pharmacology*
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / pharmacology
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / methods*
  • Polymers*
  • Prospective Studies
  • Prosthesis Design
  • Single-Blind Method
  • Sirolimus / pharmacology*
  • Time Factors

Substances

  • Immunosuppressive Agents
  • Polymers
  • Everolimus
  • Sirolimus