Author: Dr. Eva K. Bocharewicz
Affiliation: Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
Abstract
This presentation discussed the latest findings from the CoBaGi trial, which evaluates the long-term effectiveness of covered stents versus bare-metal stents in patients with chronic mesenteric ischemia (CMI). As a multicenter, double-blind randomized controlled trial, the study’s primary goal is to assess differences in primary stent patency over 24 months. Preliminary results indicate a significant advantage for covered stents in maintaining long-term patency and reducing reinterventions, positioning them as the preferred treatment for CMI patients.
Study Design
•Trial Overview: The CoBaGi trial is a multicenter, double-blind randomized controlled study aimed at comparing primary stent patency between covered stents and bare-metal stents over 24 months.
•Patient Selection: Adults with atherosclerotic CMI and lesion lengths of less than 25 mm were included. Exclusion criteria were prior stent placement and the necessity of covering vital collateral arteries.
Key Findings
• Stent Patency: At 24 months, covered stents had a significantly higher primary patency rate (92%) compared to bare-metal stents (53%). The reintervention rate was 44% in the bare-metal stent group, while it was only 9% in the covered stent group.
• Safety:Major adverse event (SAE) rates were similar between both groups, and there was no perioperative mortality in either group within 30 days.
Conclusion
1. Long-term Benefits: Covered stents demonstrated substantial long-term advantages in CMI patients, including higher stent patency and fewer reinterventions.
2. Safety: While safety outcomes were similar between the two groups, the significantly higher performance of covered stents makes them the preferred choice for most CMI patients.
3.Future Implications: The CoBaGi trial sets a strong precedent for future clinical practice, with further research needed to assess stent performance in other vascular conditions.
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