Patients treated with biodegradable polymer-coated (BP) drug-eluting stents (DES) had similar vascular healing responses at three months as patients who received durable polymer (DP) DES, according to results of the IDEAL-LM study presented Sept. 25 at TCT 2019 and simultaneously published in JACC: Cardiovascular Interventions.

The multicenter IDEAL-LM trial randomized 818 patients undergoing PCI of the unprotected left main coronary artery to either the BP-platinum-chromium everolimus-eluting stent followed by four months of dual antiplatelet therapy (DAPT) or the DP-cobalt-chromium everolimus-eluting stent followed by 12 months of DAPT.

Chun Chin Chang, MD, et al., presented the three-month results of their optical coherence tomography (OCT) substudy that evaluated vessel healing. OCT was performed in 100 patients (mean age, 64 years; 79 percent men) and analyzed by an independent core laboratory.

Of the left main stenoses, 48 percent were true bifurcation lesions and 73 percent were treated with a single stent.

The healing score was similar at three months: 2.55±5.44 vs.1.97±2.88 (p=1.00) in the BP-DES arm vs. the DP-DES arm. The proportion of covered struts was high (>96 percent for both arms) and strut malapposition was very low at <3 percent in both groups with no difference between proximal or distal segments.

"Vascular healing assessed by OCT is considered to be a safety index for using a short duration of DAPT after DES implantation," write the authors. Clinical outcomes from the IDEAL-LM will be reported after two years of follow-up.

"These results should be viewed as preliminary, because of the brief follow-up interval along with no assessment yet of the important clinical endpoints of myocardial infarction, death and repeat revascularization," says Kim A. Eagle, MD, MACC, editor-in-chief of ACC.org.

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Interventions and Imaging, Angiography, Nuclear Imaging

Keywords: TCT19, Transcatheter Cardiovascular Therapeutics, Angiography

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