THIRTY-YEARS OF STANDALONE PCI: EXPERIENCE FROM A HIGH VOLUME CANADIAN CENTRE

BACKGROUND: This study aimed to examine the clinical outcomes of a hybrid strategy of deployment of both bare metal stents (BMS) and drug-eluting stents (DES), or a strategy of exclusive DES implantation in patients undergoing multivessel percutaneous coronary intervention (PCI). METHODS: A retrospective analysis of patients with multi-vessel coronary artery disease (MVD) treated with multi-vessel PCI between April 2007 and March 2011 was performed, utilizing a prospective single-centre PCI registry. Follow up data were obtained from the discharge abstract database of the Canadian Institute for Health Information. Eligible patients had coronary arterydisease (CAD) involving twoormoremajor coronary arteries with stenoses 70% severity, and 2 stents implanted during the index procedure. Those with left main disease were excluded. RESULTS: A total of 1300 patients (514 Hybrid, 786 DES) fulfilled the study criteria.Death or target vessel revascularization at 5years occurred less often in the Hybrid group than in the DES group (26.6 3.2% vs 31.0 1.9%, p1⁄40.01). Kaplan-Meier plot for revascularization-free survival comparing propensity score matched groups is found in Figure 1. Using logistic regression, factors favouring a DES exclusive approach included LV dysfunction, diabetes mellitus, bifurcation lesions, less than TIMI 3 flow at the start of the procedure and prior PCI. Similarly factors favouring theHybrid approachwere SVGPCI andTypeC lesions. CONCLUSION: Patients who undergo Hybrid PCI have a lower incidence of MACE and TVR at 4-year follow up. For patients undergoing multi-vessel PCI who have favorable lesions and clinical features a hybrid stent approach should be considered a viable option for any contemporary PCI practice.