Treatment of multilesion coronary artery disease with simultaneous drug-eluting and bare-metal stent implantation: Clinical follow up and angiographic mid-term results

OBJECTIVES: We sought to evaluate clinical and angiographic outcomes of percutaneous coronary intervention (PCI) in patients receiving both bare-metal stents (BMS) and drug-eluting stents (DES). BACKGROUND: Few data are available about the safety and efficacy of the practice namely called "hybrid PCI". METHODS: One hundred and eighty-six patients, 502 de novo lesions, received during PCI both BMS (n ≤ 266) and DES (316), with a mean of 3.1 ± 1.2 stents/patient. Cumulative major adverse cardiac events were analyzed at 24 ± 22 months. RESULTS: Clinical follow up was carried out in 100 of eligible patients. Angiographic follow up at 8.6 ± 4.4 months was achieved in 70.4 of patients, 71.6 of stents and 72.5 of lesions. Binary restenosis was 12.9 vs. 20.6 (p ≤ 0.034) in DES vs. BMS, respectively; late loss was significantly higher in BMS than in DES (0.67 ± 0.73 vs. 0.35 ± 0.71 mm; p < 0.001). DES showed less lumen loss and binary restenosis rates than BMS in B2/C lesions (p < 0.001 and 0.007, respectively), while any significant difference was detected in A/B1 lesions (p ≤ 0.27 and 0.76, respectively). CONCLUSIONS: The simultaneous use of DES and BMS is safe and provides similar results for the 2 stents only in simple lesions. In complex lesions, BMS offer restenosis and a target lesion revascularization rates significantly higher than with DES.