Angiographic and Clinical Outcomes After Sirolimus-Eluting Stent Implantation to De Novo Ostial Lesion of the Right Coronary Artery

Background Although ostial lesion (defined as being within 3 mm of the ostia) of the right coronary artery (RCAos) has been a limitation of percutaneous coronary intervention after using previous various devices, the angiographic and clinical outcomes after the deployment of a sirolimus-eluting stent (SES) to RCAos have not been fully estimated. Therefore, the incidences of binary restenosis (BR; % diameter stenosis at chronic phase ≤50) and target lesion revascularization (TLR) after SES to RCAos were retrospectively compared with those after SES to RCA proximal (RCApro) and those after bare metal stents (BMS) to RCAos. Methods and Results The ratios of BR (18.9%) and TLR (13.5%) after SES to RCAos (n=37, mean follow-up interval of each group was 249 days) were significantly decreased compared with those of BMS to RCAos (41.7%, 36.1%, p<0.01, respectively) (n=36, 194 days), but were significantly increased compared with those of SES to RCApro (4.84%, 1.61%, p<0.01, respectively) (n=62, 240 days). There were no incidences of death, myocardial infarction, and definite stent thrombosis during the observational intervals in the entire cohort of 125 patients. Conclusions RCAos has to be taken into consideration as one of the limitations of SES because of the marked increase in the incident ratios of BR and TLR compared with those of RCApro, although SES demonstrated a likewise benefit compared with BMS. (Circ J 2008; 72: 880 - 885)