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Chronic Occlusion Revascularization with Stent Implantation Versus Coronary Angioplasty - CORSICA
Description:
Stenting after successful PTCA for 1-month clinical events in chronic occlusion.
Hypothesis:
To assess the clinical and angiographic benefits of additional stenting after successful PTCA in chronic occlusion.
Study Design
Study Design:
Patients Screened: Not given
Patients Enrolled: 142
Mean Follow Up: (ongoing)
Patient Populations:
Chronic coronary occlusion (> 15 days)
Primary Endpoints:
1 month clinical events
Drug/Procedures Used:
Palmaz-Schatz stents vs balloon PTCA.
Concomitant Medications:
ASA and Ticlopidine for 1-month post procedure in both groups.
Principal Findings:
Seventy patients were randomized into the balloon (PTCA-only) group, and 72 patients were randomized into the stent (PTCA plus additional stenting) group.
Three patients (4.3%) randomized to the balloon group required "bailout" stenting.
At one month, no adverse clinical events were reported for the stent group, while 14 events were reported for the PTCA-only group: 1 MI, 9 RePTCA, 2 CVA, 2 CABG. Seven patients in the PTCA-only group required target lesion revascularization (TLR).
At six months, 17 adverse clinical events were reported for the stent group (all RePTCA), and 33 events were reported for the PTCA-only group: 1 MI, 27 RePTCA, 2 CVA, 3 CABG. Of the patients requiring TLR, 17 were in the stent group and 24 were in the PTCA-only group.
Interpretation:
The CORSICA study was limited by the small number of patients and by the number and variation of the investigative sites. The investigators concluded that de novo coronary stenting improves short-term outcome, mainly by reducing early re-PTCA. Total events at 1 and 6 months are significantly lower in the stent group. At 6 months, there was no significant difference in TLR and clinical events detected between the two groups, although there was a trend to fewer reinterventions for the stented population.
References:
1. Eur Heart J 1998;19(Abstr Suppl):471. Preliminary results
Keywords: Coronary Artery Disease, Coronary Occlusion, Stents
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