A randomized control trial to assess optical coherence tomography parameters of the Xlimus drug-eluting stent: the XLIMIT trial.

OCT endothelialization third generation DES neointimal volume restenosis third generation DES

Journal

Frontiers in cardiovascular medicine
ISSN: 2297-055X
Titre abrégé: Front Cardiovasc Med
Pays: Switzerland
ID NLM: 101653388

Informations de publication

Date de publication:
2023
Historique:
received: 03 04 2023
accepted: 10 08 2023
medline: 25 9 2023
pubmed: 25 9 2023
entrez: 25 9 2023
Statut: epublish

Résumé

Third generation drug-eluting stents (DES) potentially offer better technical performance and reduced neointimal proliferation than previous generation DES. The XLIMIT non-inferiority trial evaluated the performance of the Xlimus (a novel sirolimus-eluting coronary stent system) in terms of endothelialization and tissue healing compared to the bioresorbable polymer Synergy DES. A total of 177 patients undergoing percutaneous coronary intervention (PCI) were randomized in a 2:1 ratio (2 Xlimus: 1 Synergy). The primary endpoints, defined as the in-stent neointimal volume weighted by the sum of the lengths of the implanted stent (ISNV) and the in-stent neointimal percent volume obstruction (%VO) were evaluated at 6-9 months by means of optical coherence tomography (OCT). Additional OCT parameters as well as clinical endpoints were also collected. Most of the patients were males (77.4%), and the mean age was 64 years. One third of the population had stable angina/silent ischemia. A total of 300 stents (237 lesions) were analyzed: 198 (152 lesions) were in the Xlimus group, and 102 (85 lesions) in the Synergy group. The ISNV in the Xlimus group was 30.7 ± 24.5 mm The study results confirm that the biological interaction of the Xlimus and Synergy DES with the coronary artery is comparable, and that translates in very reassuring OCT parameters at follow-up: as such, the Xlimus is non-inferior to the Synergy. ClinicalTrials.gov, identifier (NCT03745053).

Sections du résumé

Background UNASSIGNED
Third generation drug-eluting stents (DES) potentially offer better technical performance and reduced neointimal proliferation than previous generation DES. The XLIMIT non-inferiority trial evaluated the performance of the Xlimus (a novel sirolimus-eluting coronary stent system) in terms of endothelialization and tissue healing compared to the bioresorbable polymer Synergy DES.
Methods UNASSIGNED
A total of 177 patients undergoing percutaneous coronary intervention (PCI) were randomized in a 2:1 ratio (2 Xlimus: 1 Synergy). The primary endpoints, defined as the in-stent neointimal volume weighted by the sum of the lengths of the implanted stent (ISNV) and the in-stent neointimal percent volume obstruction (%VO) were evaluated at 6-9 months by means of optical coherence tomography (OCT). Additional OCT parameters as well as clinical endpoints were also collected.
Results UNASSIGNED
Most of the patients were males (77.4%), and the mean age was 64 years. One third of the population had stable angina/silent ischemia. A total of 300 stents (237 lesions) were analyzed: 198 (152 lesions) were in the Xlimus group, and 102 (85 lesions) in the Synergy group. The ISNV in the Xlimus group was 30.7 ± 24.5 mm
Conclusions UNASSIGNED
The study results confirm that the biological interaction of the Xlimus and Synergy DES with the coronary artery is comparable, and that translates in very reassuring OCT parameters at follow-up: as such, the Xlimus is non-inferior to the Synergy.
Clinical Trial Registration UNASSIGNED
ClinicalTrials.gov, identifier (NCT03745053).

Identifiants

pubmed: 37745092
doi: 10.3389/fcvm.2023.1199475
pmc: PMC10511894
doi:

Banques de données

ClinicalTrials.gov
['NCT03745053']

Types de publication

Journal Article

Langues

eng

Pagination

1199475

Informations de copyright

© 2023 Testa, Squillace, Ventrella, Moreno, Jiménez-Valero, Serra, Gomez Hospital, Bellamoli, Popolo Rubbio and Bedogni.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Références

Circ Cardiovasc Interv. 2010 Aug;3(4):384-93
pubmed: 20716758
J Am Coll Cardiol. 2020 Jul 14;76(2):146-158
pubmed: 32646563
JACC Cardiovasc Imaging. 2015 Nov;8(11):1297-305
pubmed: 26563859
J Am Coll Cardiol. 2012 Mar 20;59(12):1058-72
pubmed: 22421299
Circulation. 1996 Oct 1;94(7):1690-7
pubmed: 8840862
Lancet. 2004 Oct 23-29;364(9444):1519-21
pubmed: 15500897
Eur Heart J. 2012 Oct;33(20):2513-20
pubmed: 22653335
JACC Cardiovasc Interv. 2020 Jun 8;13(11):1343-1353
pubmed: 32499026
EuroIntervention. 2021 Feb 19;16(14):1187-1194
pubmed: 31062697
Catheter Cardiovasc Interv. 2006 Jul;68(1):83-8
pubmed: 16763989
Eur Heart J. 2008 Aug;29(16):1975-82
pubmed: 18550554
J Am Coll Cardiol. 2006 Dec 19;48(12):2432-9
pubmed: 17174179
Eur Heart J. 2005 Aug;26(15):1475-81
pubmed: 15975990
Circulation. 2011 Jun 28;123(25):2954-63
pubmed: 21646494
Int J Cardiol Heart Vasc. 2019 Apr 28;23:100363
pubmed: 31061876
EuroIntervention. 2018 Apr 20;13(17):2047-2050
pubmed: 28923786
EuroIntervention. 2018 Aug 20;14(6):656-677
pubmed: 29939149
Arterioscler Thromb Vasc Biol. 2007 Jul;27(7):1500-10
pubmed: 17510464
J Am Coll Cardiol. 2007 Jul 31;50(5):463-70
pubmed: 17662400
Circulation. 2007 Oct 23;116(17):1952-65
pubmed: 17965406
J Am Coll Cardiol. 2012 Apr 10;59(15):1362-70
pubmed: 22341736
Int J Cardiovasc Imaging. 2016 Jun;32(6):871-83
pubmed: 26898315
EuroIntervention. 2017 Nov 20;13(10):1210-1217
pubmed: 28741576
Am Heart Hosp J. 2007 Summer;5(3):155-8
pubmed: 17673857
Eur Heart J. 2015 Aug 21;36(32):2147-59
pubmed: 25994755
Circ Cardiovasc Interv. 2015 Apr;8(4):
pubmed: 25855680

Auteurs

Luca Testa (L)

Department of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy.

Mattia Squillace (M)

Department of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy.

Nicoletta Ventrella (N)

Department of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy.

Raul Moreno (R)

Department of Cardiology, Hospital La Paz, IdiPAZ, Madrid, Spain.

Santiago Jiménez-Valero (S)

Department of Cardiology, Hospital La Paz, IdiPAZ, Madrid, Spain.

Antoni Serra (A)

Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Joan Antoni Gomez Hospital (JA)

Department of Cardiology, Hospital Bellvitge, Barcelona, Spain.

Michele Bellamoli (M)

Department of Cardiology, Fondazione Poliambulanza, Brescia, Italy.

Antonio Popolo Rubbio (A)

Department of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy.

Francesco Bedogni (F)

Department of Cardiology, IRCCS Policlinico S. Donato, Milan, Italy.

Classifications MeSH