Sandwich drug-eluting stenting: A novel method to treat high-risk coronary lesions

Nuccia Morici, John Cosgrave, Ioannis Iakovou, Giuseppe Biondi Zoccai, Worawut Tassanawiwat, Matteo Montorfano, Giuseppe Massimo Sangiorgi, Antonio Colombo

Research output: Contribution to journalArticle

Abstract

Objectives. To describe a novel approach to drug-eluting stent (DES) implantation, the "sandwich" technique, comprised of the simultaneous implantation of two completely overlapping DES in the same target lesion. Background. DES effectively prevent restenosis in selected coronary lesions. However, adverse lesion characteristics may detrimentally affect outcomes after DES implantation by means of plaque prolapse, recoil or excessive neointimal hyperplasia. Methods. From July 2002 to November 2004, the sandwich technique was performed in 10 patients with very high-risk lesions. Two DES of identical size and length were implanted, one inside the other, with almost complete overlap. High-pressure post-dilatation (up to 28 atm) was carried out in 6 cases. The endpoints of this preliminary evaluation were: technical feasibility, early (30-day) safety, restenosis rate and freedom from adverse events at 9-month follow up. Results. Procedural and angiographic success was achieved in all cases. At follow-up, there were no deaths, myocardial infarctions or stent thromboses. All patients underwent angiographic follow-up; target lesion revascularization was carried out in 3 patients (30%). Of note, in no case was there evidence of aneurysmal remodeling. Conclusions. This study suggests that implanting 2 DES, one inside the other in a "sandwich" fashion, is feasible and apparently safe. This approach could be considered in situations such as plaque prolapse or stent recoil where additional scaffolding may be needed.

Original languageEnglish
Pages (from-to)2-5
Number of pages4
JournalJournal of Invasive Cardiology
Volume18
Issue number1
Publication statusPublished - Jan 2006

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Morici, N., Cosgrave, J., Iakovou, I., Zoccai, G. B., Tassanawiwat, W., Montorfano, M., Sangiorgi, G. M., & Colombo, A. (2006). Sandwich drug-eluting stenting: A novel method to treat high-risk coronary lesions. Journal of Invasive Cardiology, 18(1), 2-5.