Percutaneous Coronary Intervention for Very Small Vessels With the Use of a Newer-Generation 2.0 mm Drug-Eluting Stent.

OBJECTIVES The outcomes of treating coronary artery disease (CAD) in very small vessels <2.25 mm are sparse. The present study aimed to compare the safety and efficacy of the Resolute Onyx 2.0 mm drug-eluting stent (DES) (Medtronic) with the Onyx 2.25 mm DES for the treatment of CAD. METHODS We retrospectively evaluated patients who underwent percutaneous coronary intervention (PCI) for CAD involving Onyx 2.0 mm DES (Onyx 2.0 group) and Onyx 2.25 mm DES (Onyx 2.25 group) in the 2 consecutive years from November 2016 to November 2018. Major adverse cardiac and cerebral event (MACCE) rate, defined as all-cause mortality, non-fatal myocardial infarction, stroke, and repeat revascularization for target-lesion failure, was reported. RESULTS A total of 152 subjects with 160 lesions were enrolled. The baseline demographics, lesion characteristics, and procedural results between the two groups were similar. The lesions were significantly shorter (P<.01), fewer stents were consequently deployed (P=.04), and the total stent length was shorter (P<.01) in the Onyx 2.0 group vs the Onyx 2.25 group. At a median follow-up of 673 days, MACCE rate did not differ significantly between the two groups. Multivariate analysis identified the presence of atrial fibrillation, chronic kidney disease, and the use of statins to be independently associated with MACCE. CONCLUSIONS Our data suggest that the use of the Onyx 2.0 mm DES to treat CAD in very small vessels (<2.25 mm) is feasible and safe, and the clinical outcomes were similar to those of the Onyx 2.25 mm group.