From the Guidelines
The most effective alternative to Supera is a drug-eluting stent, which should be considered in subsets of patients where trial data suggest efficacy, as recommended by the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention 1. When considering alternatives to Supera, it is essential to evaluate the patient's specific condition and the available treatment options.
- The ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention suggests that a drug-eluting stent may be considered for use in anatomic settings where the usefulness, effectiveness, and safety have not been fully documented in published trials, with a Level of Evidence: C 1.
- According to the guideline, a drug-eluting stent should be considered as an alternative to the bare-metal stent in subsets of patients in whom trial data suggest efficacy, with a Level of Evidence: A 1.
- The use of drug-eluting stents has been shown to be effective in reducing the risk of restenosis and improving clinical outcomes in patients with coronary artery disease, as discussed in the Circulation journal article 1.
- Factors such as small vessel size, smaller postprocedure minimum lumen diameter, higher residual percent diameter stenosis, lesions located in the LAD, stent length, and the presence of diabetes mellitus can increase the propensity to develop stent restenosis, as reported in the Circulation journal article 1.
- The choice of alternative to Supera depends on individual factors, including comorbidities, age, and potential side effects, and should be guided by the most recent and highest-quality evidence available.
- In the context of percutaneous coronary intervention, the use of drug-eluting stents has become increasingly important, and their effectiveness in preventing restenosis has been demonstrated in several studies, including those discussed in the Journal of the American College of Cardiology article 1.
From the Research
Alternatives to Supera
- There are several alternatives to Supera, including:
- Drug-eluting balloons (DEB)
- Everolimus-eluting stents (EES)
- Sirolimus-eluting stents
- Zotarolimus-eluting stents
- Biolimus A9-eluting stents
Comparison of Alternatives
- A study comparing DEB and EES in patients with bare-metal stent-in-stent restenosis found that DEB were associated with a lower rate of major adverse cardiac events (MACE) at 1 year 2
- Another study found that EES reduced the need for target lesion revascularization at very long-term follow-up compared to DEB in patients with bare-metal stent in-stent restenosis 3
- A randomized clinical trial comparing DEB with EES in patients with bare-metal stents in-stent restenosis found that EES provided superior late angiographic findings, but similar clinical results 4
- A review of clinical studies with sirolimus, zotarolimus, everolimus, and biolimus A9 drug-eluting stent systems found that these stents have revolutionized the field of interventional cardiology by reducing restenosis rates and the need for repeat intervention 5
Efficacy and Safety
- The BIO-RESORT trial found that very thin strut biodegradable polymer everolimus-eluting and sirolimus-eluting stents were non-inferior to durable polymer zotarolimus-eluting stents in treating allcomers with a high proportion of patients with acute coronary syndromes 6
- The RIBS V Clinical Trial found that EES and DEB were safe and effective in patients treated for bare-metal stent in-stent restenosis, with a low rate of clinical and angiographic recurrences 3, 4