033 Drug eluting stent percutaneous angioplasty: The experience of the tertiary region of Sfax

Introduction Several clinical trials have validated the effectiveness of drug eluting stents (DES) and its benefit comparing to bare-metal stent for restenosis rate reduction after angioplasty. But the major disadvantage of DES is thrombosis. The aim of this study is to describe clinical and angiographic outcomes of DES implantation in Sfax Cardiology Departments (public and private centers). Patients and methods Our study is retrospective including 619 patients undergoing percutaneous angioplasty by 769 eluding stents during the period between juillet 2003 and June 2009. Results The mean age was 63,25 years and most patients were men (80,7%). The majority of patients (61, 6%) were diabetic. Most patients (46, 3%) had multivessel disease. Coronary lesion sites were located mainly on the left descending coronary artery at 71, 4%. The mean diameter stent was 2, 93 ± 0,37 mm, and the mean length was 26,95 ± 6,91 mm. Coronary lesion was in the most time long (in 43,1%). We used Taxus stents in 81,4% of cases. The stenting was direct in 72,1% of procedures, and after dilatation in 22 procedures%. A post inflation was achieved in 11,3% of procedures. The mean of pression inflation was 14, 29 mmhg. The angiographic success was noted in 100%. The mean follow-up was 18, 26 months. Acute instent thrombosis occurred in 3,7% (23 patients/619 patients). One case of acute thrombosis, 21 cases of subacute thrombosis, one case of late thrombosis, no case of verylate thrombosis was noted. On the Follow up, an angiographic control was performed in 8,3% des cas (49 patients). A restenosis in stent was noted in 16% and new lesions were noted in 3,6% of cases. MACE rate was 10,2% with 2,5% of mortality. Conclusion The high price of drug eluting stents relative to bare stents has been an obstacle to widespread utilization of drug eluting stents in our tertiary region. These latter are more interesting for diabetic persons and complex lesions but they are limited by the risk of acute and late thrombosis.