Inhibition of Restenosis with a Paclitaxel-Eluting, Polymer-Free Coronary Stent: The European evaLUation of pacliTaxel Eluting Stent (ELUTES) Trial

Anthony Gershlick, Ivan De Scheerder, Bernard Chevalier, Amanda Stephens-Lloyd, Edoardo Camenzind, Christian Vrints, Nicolaus Reifart, Luc Missault, Jean Jacques Goy, Jeffrey A. Brinker, Albert E. Raizner, Philip Urban, Alan W. Heldman

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Abstract

Background-The use of a stent to deliver a drug may reduce in-stent restenosis. Paclitaxel interrupts the smooth muscle cell cycle by stabilizing microtubules, thereby arresting mitosis. Methods and Results-On the basis of prior animal studies, the European evaLUation of the pacliTaxel Eluting Stent (ELUTES) pilot clinical trial (n = 190) investigated the safety and efficacy of V-Flex Plus coronary stents (Cook Inc) coated with escalating doses of paclitaxel (0.2, 0.7, 1.4, and 2.7 μg/mm2 stent surface area) applied directly to the abluminal surface of the stent in de novo lesions compared with bare stent alone. The primary efficacy end point was angiographic percent diameter stenosis at 6 months. At angiographic follow-up, percent diameter stenosis was 33.9×26.7% in controls (n=34) and 14.2±16.6% in the 2.7-μg/mm2 group (n=31; P=0.006). Late loss decreased from 0.73×0.73 to 0.11±0.50 mm (P=0.002). Binary restenosis (≥50% at follow-up) decreased from 20.6% to 3.2% (P=0.056), with no significant benefit from intermediate paclitaxel doses. Freedom from major adverse cardiac events in the highest (effective) dose group was 92%, 89%, and 86% at 1, 6, and 12 months, respectively (P=NS versus control). No late stent thromboses were seen in any treated group despite clopidogrel treatment for 3 months only. Conclusions-Paclitaxel applied directly to the abluminal surface of a bare metal coronary stent, at a dose density of 2.7 μg/mm2, reduced angiographic indicators of in-stent restenosis without short- or medium-term side effects.

Original languageEnglish (US)
Pages (from-to)487-493
Number of pages7
JournalCirculation
Volume109
Issue number4
DOIs
StatePublished - Feb 3 2004

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Keywords

  • Paclitaxel
  • Restenosis
  • Stents

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Gershlick, A., De Scheerder, I., Chevalier, B., Stephens-Lloyd, A., Camenzind, E., Vrints, C., Reifart, N., Missault, L., Goy, J. J., Brinker, J. A., Raizner, A. E., Urban, P., & Heldman, A. W. (2004). Inhibition of Restenosis with a Paclitaxel-Eluting, Polymer-Free Coronary Stent: The European evaLUation of pacliTaxel Eluting Stent (ELUTES) Trial. Circulation, 109(4), 487-493. https://doi.org/10.1161/01.CIR.0000109694.58299.A0