LONG DES-II Study data suggest sirolimus-eluting stents are superior to paclitaxel-eluting stents for long, complex coronary lesions, according to a presentation at the annual meeting of the American College of Cardiology.

The LONG DES-II Study (percutaneous treatment of long native coronary lesions with Drug-Eluting Stents II) was designed to compare the angiographic in-segment binary restenosis rate of CYPHER(R) (sirolimus-eluting) stents and Taxus (paclitaxel-eluting) stents at six months. The study was conducted across five medical centers in Korea and included 500 patients (250 in the CYPHER(R) Stent arm and 250 in the Taxus Stent arm). Lesion length needed to be greater than 25 mm. It is estimated that long lesions such as these comprise approximately 20 percent of cases treated by interventional cardiologists.

"In this study, the CYPHER(R) Stent showed better outcomes than the Taxus Stent in these complex, long lesions. Patients with very long lesions are among the most difficult to treat and tend to be at higher risk of restenosis," said Seung-Jung Park, MD, PhD, FACC, Principal Investigator and Chief of Interventional Cardiology, ASAN Medical Center, Seoul, Korea. "These findings provide important new information for clinicians to consider when choosing the best treatment for these types of complex patients."

Myeong-Ki Hong, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Department of Internal Medicine, University of Ulsan, College of Medicine, Seoul, Korea, presented the findings on Dr. Park's behalf. The ASAN Medical Center is the teaching affiliate hospital of Ulsan University, Korea.

In the study, the patients received a mean total stent length of about 41 mm. Patients receiving the sirolimus-eluting stent had significantly less in-stent late loss than patients treated with the paclitaxel-eluting stent and 71 percent less in-segment restenosis than patients treated with the paclitaxel-eluting stent (3 percent for sirolimus stents versus 10.3 percent for paclitaxel stents).

Additionally, patients treated with sirolimus-eluting stents had significantly larger minimal in-stent diameter at follow-up than patients treated with paclitaxel-eluting stents (2.39 mm vs. 2.04 mm), which is important for blood flow, and a lower average in-stent diameter stenosis than those treated with paclitaxel-eluting stents.

Secondary endpoints included in-segment and in-stent restenosis at six months as well as Major Adverse Cardiac Events, an important safety and efficacy outcome measure which comprises all-cause death, myocardial infarction and target lesion revascularization. At the nine-month clinical follow-up, the major event rates were 3 percent for sirolimus-eluting stents versus 7.8 percent for paclitaxel-eluting stents.