Drug-eluting stent thrombosis in the treatment of chronic total coronary occlusions: Incidence, presentation and related factors. Data from the CIBELES trial | Revista Portuguesa de Cardiologia (English edition)

array:23 ["pii" => "S2174204915000604" "issn" => "21742049" "doi" => "10.1016/j.repce.2015.03.005" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "602" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2014" "documento" => "article" "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2015;34:193-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2936 "formatos" => array:3 [ "EPUB" => 172 "HTML" => 2300 "PDF" => 464 ] ] "itemSiguiente" => array:19 [ "pii" => "S2174204915000525" "issn" => "21742049" "doi" => "10.1016/j.repce.2014.10.003" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "600" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "ssu" "cita" => "Rev Port Cardiol. 2015;34:201-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5009 "formatos" => array:3 [ "EPUB" => 160 "HTML" => 4005 "PDF" => 844 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Review article" "titulo" => "Galectin-3, a prognostic marker – and a therapeutic target?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "201" "paginaFinal" => "208" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Galectina-3: indicador de prognóstico. Alvo de intervenção terapêutica?" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1380 "Ancho" => 1487 "Tamanyo" => 95453 ] ] "descripcion" => array:1 [ "en" => "Median galectin-3 levels among heart failure patients who died (n=17) within 60 days and those who survived (n=192). Results from the PRIDE subanalysis. Reproduced with permission from van Kimmenade et al.<a class="elsevierStyleCrossRef" href="#bib0150">3</a>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Rita Pereira, Luiz Menezes Falcão" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Ana Rita" "apellidos" => "Pereira" ] 1 => array:2 [ "nombre" => "Luiz" "apellidos" => "Menezes Falcão" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S0870255115000359" "doi" => "10.1016/j.repc.2014.10.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115000359?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000525?idApp=UINPBA00004E" "url" => "/21742049/0000003400000003/v2_201504010220/S2174204915000525/v2_201504010220/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2174204915000264" "issn" => "21742049" "doi" => "10.1016/j.repce.2014.08.016" "estado" => "S300" "fechaPublicacion" => "2015-03-01" "aid" => "564" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2015;34:179-91" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4820 "formatos" => array:3 [ "EPUB" => 159 "HTML" => 3586 "PDF" => 1075 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Systematic review of cost-effectiveness analyses of novel oral anticoagulants for stroke prevention in atrial fibrillation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "179" "paginaFinal" => "191" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Revisão sistemática das análises custo-efetividade dos novos anticoagulantes orais na prevenção do acidente vascular cerebral na fibrilhação auricular: estudo AFFORD" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2885 "Ancho" => 2987 "Tamanyo" => 516426 ] ] "descripcion" => array:1 [ "en" => "Graphical representation of the results of the AFFORD study, showing incremental cost-effectiveness ratios (ICER) in euros per quality-adjusted life year (QALY) after currency conversion when necessary. The vertical line represents the willingness-to-pay threshold of 30 000 euros per QALY adopted in Portugal." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "João Ferreira, Ana Mirco" "autores" => array:2 [ 0 => array:2 [ "nombre" => "João" "apellidos" => "Ferreira" ] 1 => array:2 [ "nombre" => "Ana" "apellidos" => "Mirco" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S0870255114003114" "doi" => "10.1016/j.repc.2014.08.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255114003114?idApp=UINPBA00004E" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000264?idApp=UINPBA00004E" "url" => "/21742049/0000003400000003/v2_201504010220/S2174204915000264/v2_201504010220/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "Original Article" "titulo" => "Drug-eluting stent thrombosis in the treatment of chronic total coronary occlusions: Incidence, presentation and related factors. Data from the CIBELES trial" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "193" "paginaFinal" => "199" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Eduardo Arroyo-Úcar, Raul Moreno, Eulogio García, Rui Teles, Jose-Ramon Rumoroso, Henrique Cyrne Carvalho, Francisco Javier Goicolea, José Moreu, Josefa Mauri, Manel Sabaté, Vicente Mainar, Lino Patricio, Mariano Valdés, Felipe Fernández-Vázquez, Angel Sánchez-Recalde, Guillermo Galeote, Santiago Jimenez-Valero, Manuel Almeida, Esteban López de Sa, Luis Calvo, Ignacio Plaza, Jose-Luis Lopez-Sendón, Jose-Luis R. Martín" "autores" => array:24 [ 0 => array:3 [ "nombre" => "Eduardo" "apellidos" => "Arroyo-Úcar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Raul" "apellidos" => "Moreno" "email" => array:1 [ 0 => "raulmorenog@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Eulogio" "apellidos" => "García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Rui" "apellidos" => "Teles" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Jose-Ramon" "apellidos" => "Rumoroso" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] ] ] 5 => array:3 [ "nombre" => "Henrique Cyrne" "apellidos" => "Carvalho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "e" "identificador" => "aff0025" ] ] ] 6 => array:3 [ "nombre" => "Francisco Javier" "apellidos" => "Goicolea" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "f" "identificador" => "aff0030" ] ] ] 7 => array:3 [ "nombre" => "José" "apellidos" => "Moreu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "g" "identificador" => "aff0035" ] ] ] 8 => array:3 [ "nombre" => "Josefa" "apellidos" => "Mauri" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "h" "identificador" => "aff0040" ] ] ] 9 => array:3 [ "nombre" => "Manel" "apellidos" => "Sabaté" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "i" "identificador" => "aff0045" ] ] ] 10 => array:3 [ "nombre" => "Vicente" "apellidos" => "Mainar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "j" "identificador" => "aff0050" ] ] ] 11 => array:3 [ "nombre" => "Lino" "apellidos" => "Patricio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "k" "identificador" => "aff0055" ] ] ] 12 => array:3 [ "nombre" => "Mariano" "apellidos" => "Valdés" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "l" "identificador" => "aff0060" ] ] ] 13 => array:3 [ "nombre" => "Felipe" "apellidos" => "Fernández-Vázquez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "m" "identificador" => "aff0065" ] ] ] 14 => array:3 [ "nombre" => "Angel" "apellidos" => "Sánchez-Recalde" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 15 => array:3 [ "nombre" => "Guillermo" "apellidos" => "Galeote" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 16 => array:3 [ "nombre" => "Santiago" "apellidos" => "Jimenez-Valero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 17 => array:3 [ "nombre" => "Manuel" "apellidos" => "Almeida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 18 => array:3 [ "nombre" => "Esteban" "apellidos" => "López de Sa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 19 => array:3 [ "nombre" => "Luis" "apellidos" => "Calvo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 20 => array:3 [ "nombre" => "Ignacio" "apellidos" => "Plaza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 21 => array:3 [ "nombre" => "Jose-Luis" "apellidos" => "Lopez-Sendón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 22 => array:3 [ "nombre" => "Jose-Luis R." "apellidos" => "Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "n" "identificador" => "aff0070" ] ] ] 23 => array:1 [ "colaborador" => "for the CIBELES investigators" ] ] "afiliaciones" => array:14 [ 0 => array:3 [ "entidad" => "Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Clinico, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Hospital de Santa Cruz, Lisbon, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Hospital de Galdakao, Bilbao, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Hospital de Santo Antonio, Porto, Portugal" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Hospital Puerta de Hierro, Majadahonda, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Hospital Virgen de la Salud, Toledo, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Hospital German Trias I Pujol, Badalona, Spain" "etiqueta" => "h" "identificador" => "aff0040" ] 8 => array:3 [ "entidad" => "Hospital Santa Creu I Sant Pau, Barcelona, Spain" "etiqueta" => "i" "identificador" => "aff0045" ] 9 => array:3 [ "entidad" => "Hospital General, Alicante, Spain" "etiqueta" => "j" "identificador" => "aff0050" ] 10 => array:3 [ "entidad" => "Hospital de Santa Marta, Lisboa, Portugal" "etiqueta" => "k" "identificador" => "aff0055" ] 11 => array:3 [ "entidad" => "Hospital Virgen de la Arrixaca, Murcia, Spain" "etiqueta" => "l" "identificador" => "aff0060" ] 12 => array:3 [ "entidad" => "Complejo Hospitalario, León, Spain" "etiqueta" => "m" "identificador" => "aff0065" ] 13 => array:3 [ "entidad" => "Research Manager, School of Biomedical and Health Sciences, Universidad Europea de Madrid, Spain" "etiqueta" => "n" "identificador" => "aff0070" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Trombose do stent fármaco ativo no tratamento da oclusões totais coronárias: incidência, apresentação e fatores relacionados. Os dados do ensaio Cibeles" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1262 "Ancho" => 1568 "Tamanyo" => 137687 ] ] "descripcion" => array:1 [ "en" => "Incidence of definite and probable stent thrombosis at 12-month follow-up (overall rate 1.4%). EES: everolimus-eluting stent; SES: sirolimus-eluting stent; ST: stent thrombosis." ] ] ] "textoCompleto" => "IntroductionChronic total coronary occlusions (CTO) constitute one of the most complex and challenging therapeutic scenarios for an interventional cardiologist, due not only to the technical complexity of the lesion and the need for specific operator skills, but also to the many complications that can occur during and after the procedure.<a class="elsevierStyleCrossRefs" href="#bib0175">1–4</a> Stent thrombosis (ST) represents the most important clinical complication due to the high rate of death and/or myocardial infarction.<a class="elsevierStyleCrossRef" href="#bib0195">5</a> Its pathophysiology includes various factors related to the device itself, the procedure and the patient.<a class="elsevierStyleCrossRef" href="#bib0200">6</a>It has been traditionally considered that one the factors associated with increased risk of ST is, as suggested by some studies,<a class="elsevierStyleCrossRefs" href="#bib0205">7,8</a> the implantation of a drug-eluting stent (DES) in the context of a CTO. The aim of this study is to assess the incidence, clinical significance and timing of DES thrombosis in the treatment of CTO, given the lack of clear knowledge concerning the safety of these devices in this context. For this purpose, data on ST from the CIBELES trial<a class="elsevierStyleCrossRef" href="#bib0215">9</a> were studied.MethodsPatientsThe CIBELES clinical trial (ClinicalTrials.gov number <a href="ctgov:NCT00793221">NCT00793221</a>) included 207 patients with CTO of more than two weeks duration, after successful balloon angioplasty. These patients were randomized to receive an everolimus-eluting stent (EES) (Xience V, Abbott Vascular) or a sirolimus-eluting stent (SES) (Cypher, Cordis). The primary outcome was in-stent late loss. Thirteen centers in Spain and Portugal were involved in this trial, which was sponsored by the Spanish Society of Cardiology. Abbott Vascular supported the study by an unconditional grant.The antithrombotic therapy, approach (radial or femoral) and material used during the procedure were chosen according to operator preferences or the established protocols of each center. Angiographic follow-up was performed at nine months after revascularization. In the event of significant restenosis, repeat revascularization was performed, if clinically indicated (angina, silent ischemia or presence of myocardial viability) and technically feasible. Quantitative coronary analysis was performed at an independent laboratory using MEDIS software (Leiden, The Netherlands). The study was monitored by Chiltern International, and featured an independent clinical events committee. The clinical follow-up was performed over a period of 12 months after revascularization.This substudy assesses the incidence, timing, clinical presentation and independent predictors of ST in patients included in the CIBELES trial.DefinitionsThe definition of ST used was that of the Academic Research Consortium,<a class="elsevierStyleCrossRef" href="#bib0220">10</a> as follows:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005">(1)definite thrombosis: documented angiographically or by autopsy;</li><li class="elsevierStyleListItem" id="lsti0010">(2)probable thrombosis: an acute coronary syndrome in the territory of the treated artery, or either sudden cardiac or unexplained death in the 30 days after stent implantation;</li><li class="elsevierStyleListItem" id="lsti0015">(3)possible thrombosis: sudden cardiac or unexplained death beyond 30 days after stent implantation.</li></ul>In view of these criteria, of special interest for the study were the rates of definite or probable thrombosis. From a chronological point of view, thrombosis was considered as:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0020">(1)acute: within 24 hours after stent implantation;</li><li class="elsevierStyleListItem" id="lsti0025">(2)sub-acute: between the first 24 hours and the first 30 days after stent implantation;</li><li class="elsevierStyleListItem" id="lsti0030">(3)late: beyond the first 30 days after stent implantation.</li></ul>Statistical analysisThe collected data were analyzed using SPSS version 12.0 for Windows (SPSS Inc., Chicago, IL, USA). Qualitative variables were expressed as percentages, and quantitative variables as mean ± standard deviation. The chi-square test and Fisher's exact test were used to compare qualitative variables. Multivariate analysis was performed using logistic regression analysis. Comparison between quantitative variables was performed using the Student's t test. A value of p<0.05 was considered statistically significant.ResultsIncidence and clinical presentation of stent thrombosisThe clinical and angiographic characteristics of the study population are summarized in <a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>. During follow-up, ST was diagnosed in three patients, two definite (1 and 117 days after the procedure) and one probable (nine days after the procedure). The characteristics of these patients are summarized in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia>The first patient was randomized to the SES group and received three stents. However, a paclitaxel-eluting stent was also implanted distally to the treated lesion. Within 24 hours of the procedure the patient presented acute ST of the paclitaxel device. Although there was no evidence of thrombosis of the SES, this event was classified as definite ST as the design of the analysis was by intention to treat.The second patient experienced a non-ST-elevation acute coronary syndrome nine days after the initial intervention. This event was initially treated conservatively. At the scheduled angiographic follow-up, coronary angiography demonstrated total occlusion of the target vessel. ST was considered the most likely cause of the event.A third patient had a definite ST, 117 days after treatment. This patient was admitted with a non-ST-elevation acute coronary syndrome; angiography showed a thrombotic occlusion of the treated target vessel and PCI was subsequently repeated.The overall rate of definite or probable thrombosis was therefore 1.4% (0.9% early, 0.5% late). In no case did ST lead to death or Q-wave myocardial infarction. The clinical presentation was non-Q-wave myocardial infarction in two cases and unstable angina in one. There were also no documented cases of probable or definite ST in patients assigned to the EES group.A fourth patient had sudden death of unknown cause eight months after the coronary intervention. ST was considered in this case as possible. Thus, the overall incidence of ST (definite, probable or possible) was 1.8%.Factors related to stent thrombosisThe univariate analysis (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>) revealed that patients with a higher incidence of ST were those who had single-vessel disease (3.3% vs. 0.0%, p=0.049), in whom the lesion was in the anterior descending artery (3.5% vs. 0.0%, p=0.037), and who showed a lower minimum luminal diameter (1.3±0.6 mm vs. 2.6±0.5 mm, p<0.001) immediately after the procedure. Moreover, the ST rate was 3.0% in the SES group compared to 0.0% in the EES group (p=0.074) (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). Multivariate analysis showed that the only independent predictor of ST in this context was minimal lumen diameter immediately after the procedure (p=0.012).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>DiscussionST is an uncommon event, with a variable clinical presentation but generally unfavorable course, resulting in high rates of myocardial infarction (50–70%) or death (20–40%). The data in the literature on its incidence are inconsistent, but it is estimated at between 0.5% and 2.5%. These figures are slightly lower and with earlier clinical presentation for bare-metal stents (BMS).<a class="elsevierStyleCrossRef" href="#bib0215">9</a>The essential pathophysiology is closely related to various parameters and chronological stages: early events often depend on variables associated with the procedure itself, including the presence of residual thrombus, dissection in the proximity of the target lesion, stasis, stent under-expansion, stent length, or a combination of the above. Late events are most frequently associated with delayed scarring or incomplete and/or inadequate neointimal covering. Additionally, underlying vascular inflammation and the length of the implanted devices have also been shown to be important, with patients who had received longer stents or experienced an allergic reaction to the polymer most often suffering ST.<a class="elsevierStyleCrossRefs" href="#bib0225">11–13</a>Traditionally, percutaneous revascularization of a CTO is considered to be at high risk for ST. This is due to the complexity of the procedure and the intricate histopathology of these lesions, which contain varying amounts of collagen, lipid, calcifications and intraluminal microchannels. All this leads to increased vulnerability and susceptibility to vascular damage.<a class="elsevierStyleCrossRefs" href="#bib0240">14,15</a> Numerous clinical studies have demonstrated the superiority of DES (mainly SES) compared with BMS in the treatment of CTO,<a class="elsevierStyleCrossRefs" href="#bib0250">16–21</a> with a lower restenosis rate and fewer major adverse cardiac events. There are no data in the literature that conclusively demonstrate increased rates of ST in this context. However, ST is slightly more frequent in patients treated with first-generation DES.The new generations of DES have been developed to improve safety and biocompatibility, optimizing the three main components: the platform, the polymer and the drug. They have been shown to be more effective than the first generation, mainly due to a reduction in the rate of medium-term target vessel revascularization. They have also shown a better safety profile, with lower rates of ST. These findings have been supported by the results of numerous clinical trials published in recent years (SPIRIT II,<a class="elsevierStyleCrossRef" href="#bib0280">22</a> SPIRIT III,<a class="elsevierStyleCrossRef" href="#bib0285">23</a> SPIRIT IV,<a class="elsevierStyleCrossRef" href="#bib0290">24</a> COMPARE I<a class="elsevierStyleCrossRef" href="#bib0295">25</a>), which compared the two generations of DES.So the results of the CIBELES trial, which demonstrates the non-inferiority of EES versus SES, should not surprise us. They corroborate the previously published data and establish the safety of EES in the context of CTO. Although it is not possible to draw definite conclusions concerning differences in ST between the two treatment groups, there were no cases of definite or probable thrombosis in the EES arm. Other second-generation stents, such as zotarolimus-eluting stents, have been proven to be at least as effective as SES in the treatment of CTO, offering similar results in terms of numbers of ST.<a class="elsevierStyleCrossRef" href="#bib0300">26</a>As noted above, ST usually presents as an acute event with a variable spectrum, but usually with high rates of morbidity and mortality. However, in our study the clinical course was relatively benign, presenting in all cases as an episode of unstable angina or a nonfatal non-ST-elevation myocardial infarction. The particular angiographic scenario probably contributed significantly to this clinical course, as pre-existing collateral circulation may have played a protective role in the event of an ischemic event caused by ST.The data obtained suggest that the only independent predictor of ST is minimal luminal diameter immediately after the procedure. This suggests that stents implanted in small vessels or malpositioned or under-expanded (due to, for example, the existence of underlying calcium) are at higher risk of thrombosis. Recently published data emphasize the low use of non-compliant balloons in the treatment of CTO. In the CIBELES trial, post-dilatation was only performed in 25% of patients, a figure that is surprising given the expected proportion of malpositioning or under-expansion of the implanted stents according to the type and length of the treated lesions. Invasive imaging techniques such as IVUS guided the procedure and its outcome in only 6% of cases.<a class="elsevierStyleCrossRef" href="#bib0305">27</a>It is known that the same precipitating factors are predictors of ST after revascularization with DES in other coronary lesions.<a class="elsevierStyleCrossRefs" href="#bib0310">28,29</a> Analyzing the timing of the event rate, there is no evidence of a clear grouping, with one acute, one subacute, and one late ST in our study. The two early events were presumably related to the procedure itself and associated local complications. Stenting often leads to areas of dissection along the artery, and together with the presence of organized thrombotic material, areas of calcification and suboptimal end TIMI flow, would provide the pathophysiological basis for increased incidence of ST. However, and despite the complexity of the procedure, the frequency of acute and subacute ST is very low, representing only 0.97% of all our cases.Furthermore, thrombosis associated with DES occurs later than with BMS.<a class="elsevierStyleCrossRef" href="#bib0310">28</a> The main cause of this phenomenon is delayed endothelialization of the device, caused by the antiproliferative action of the drug, as indicated by various angioscopy, optical coherence tomography and autopsy studies, although no definite conclusions can be drawn.<a class="elsevierStyleCrossRefs" href="#bib0320">30,31</a> We found only one case of late ST, but the follow-up in our study was only 12 months after revascularization. Hence, possible very late thrombosis events were not recorded.In light of the above, we consider that this substudy of the CIBELES trial shows that ST in the context of CTO treated with DES is an uncommon phenomenon, similar to that of other coronary lesions. The previously known predisposing factors account for the majority of the risk, although the importance of certain local factors, such as the frequent presence of underlying calcium or areas of arterial dissection, should be borne in mind. Our data are similar to those published by other groups, in which the efficacy of EES<a class="elsevierStyleCrossRef" href="#bib0330">32</a> and other second-generation stents<a class="elsevierStyleCrossRefs" href="#bib0335">33,34</a> was assessed, suggesting the existence of a class effect.Moreover, second-generation DES have tended to diminish ST and are probably better in this regard than the first generation. The clinical presentation is in this context milder than in other circumstances, as the abundant collateral circulation acts as insurance and protects possible at-risk myocardial territory. Therefore, and given the available scientific evidence, we believe that DES stenting in CTO – and even more with second-generation stents – does not lead to added risk of ST, and presents a clear benefit in restenosis rates.<a class="elsevierStyleCrossRef" href="#bib0275">21</a> Invasive imaging techniques such as IVUS or optical coherence tomography, and the use of non-compliant balloons after stent implantation, are useful tools to predict and correct malpositioning or under-expansion, thereby alleviating some of the main triggers of thrombosis.Study limitationsOur study has some limitations. First, the CIBELES trial was designed to compare stent restenosis with EES and SES, and not to study ST. However, it is not really feasible to perform a specific clinical trial to assess ST in the context of CTO. Secondly, CTO were defined as those with estimated occlusion time >2 weeks (and not >3 months as recommended in recent consensus documents). The data are thus comparable to those of other trials of DES in CTO, such as PRISON II.<a class="elsevierStyleCrossRef" href="#bib0275">21</a> In any case, in our study the estimated duration of occlusion was not related to the rate of ST. Thirdly, since the choice of antiplatelet therapy was at the discretion of the operator, there was no uniformity concerning the dose and type of drug administered. Finally, the clinical monitoring of patients was conducted over a 12-month period, so events after this period were not recorded. Consequently, despite its low incidence, possible very late ST is not included in this study.ConclusionsThe rate of thrombosis of DES in patients with CTO is low (1.4%), especially in those treated with EES compared to SES. In this context, the only independent predictor is minimal luminal diameter after the procedure. The clinical presentation in all cases was relatively benign (unstable angina or nonfatal non-ST-elevation myocardial infarction). The use of DES in the treatment of CTO is a safe option and should not be considered to increase risk of thrombosis.Ethical disclosuresProtection of human and animal subjectsThe authors declare that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association (Declaration of Helsinki).Confidentiality of dataThe authors declare that they have followed the protocols of their work center on the publication of patient data.Right to privacy and informed consentThe authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.Conflicts of interestThis study was supported by the Spanish Society of Cardiology, with an unrestricted grant by Abbott Vascular." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:3 [ "identificador" => "xres469301" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec491912" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres469300" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introdução e objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec491913" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Patients" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Definitions" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Statistical analysis" ] ] ] 6 => array:3 [ "identificador" => "sec0030" "titulo" => "Results" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Incidence and clinical presentation of stent thrombosis" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Factors related to stent thrombosis" ] ] ] 7 => array:2 [ "identificador" => "sec0045" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0050" "titulo" => "Study limitations" ] 9 => array:2 [ "identificador" => "sec0055" "titulo" => "Conclusions" ] 10 => array:3 [ "identificador" => "sec0060" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0065" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0070" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0075" "titulo" => "Right to privacy and informed consent" ] ] ] 11 => array:2 [ "identificador" => "sec0080" "titulo" => "Conflicts of interest" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-07-15" "fechaAceptado" => "2014-08-16" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec491912" "palabras" => array:5 [ 0 => "Stent" 1 => "Thrombosis" 2 => "Everolimus" 3 => "Sirolimus" 4 => "Chronic total coronary occlusion" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec491913" "palabras" => array:5 [ 0 => "Stent" 1 => "Trombose" 2 => "Everolimus" 3 => "Sirolimus" 4 => "Oclusão coronária crónica total" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "Introduction and ObjectivesThe aim of this study was to analyze the incidence of drug-eluting stent thrombosis (sirolimus or everolimus) in patients with chronic total coronary occlusions (CTO) and to determine its clinical implications and related factors. MethodsData from the 12-month follow-up of the 207 patients included in the CIBELES trial with CTO were analyzed. ResultsStent thrombosis occurred in three patients, two definite and one probable (overall thrombosis rate: 1.4%). However, there were no cases of death or Q-wave myocardial infarction. In univariate analysis, patients with a higher incidence of stent thrombosis were those in whom the target vessel was the left anterior descending, who had single-vessel disease, were assigned to treatment with sirolimus-eluting stents, and those with smaller minimum luminal diameter immediately after the procedure. In multivariate analysis, the only independent predictor of stent thrombosis was minimal luminal diameter immediately after the procedure. ConclusionsThe rate of drug-eluting stent thrombosis in patients with CTO is relatively low (1.4%). The only independent predictor of stent thrombosis in this context was minimal luminal diameter after the procedure and the clinical presentation was in all cases relatively benign." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and Objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "Introdução e objetivoso objetivo do nosso estudo foi analisar a incidência de trombose de stent com eluição de fármaco (sirolimus ou everolimus) em pacientes com oclusões coronárias crónicas e identificar as suas implicações clínicas e fatores relacionados. Métodos12 meses de acompanhamento dos 207 pacientes incluídos no ensaio Cibeles com oclusão total coronária crónica. Resultadosa trombose de stent ocorreu em três doentes: duas definitivas e uma provável (taxa global de trombose 1,4%). No entanto, não surgiu nenhum caso de morte ou enfarte do miocárdio com onda Q. Na análise univariada, os doentes com maior incidência de trombose de stent foram aqueles em que o vaso-alvo foi a descendente anterior, os que tinham a doença de um vaso, os que foram considerados para tratamento com stent com sirolimus, e aqueles com diâmetro luminal mínimo menor imediatamente após o procedimento. Na análise multivariada, o único preditor independente de trombose do stent foi o diâmetro luminal mínimo imediatamente após o procedimento. Conclusõesa taxa de trombose de stent farmacológico em pacientes com oclusão coronária crónica foi relativamente baixa (1,4%).O único preditor independente de trombose de stent neste contexto foi o diâmetro luminal mínimo após o procedimento, tendo a apresentação clínica em todos os casos sido relativamente benigna." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introdução e objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusões" ] ] ] ] "nomenclatura" => array:1 [ 0 => array:3 [ "identificador" => "nom0005" "titulo" => "List of abbreviations" "listaDefinicion" => array:1 [ 0 => array:1 [ "definicion" => array:6 [ 0 => array:2 [ "termino" => "CTO" "descripcion" => "chronic total occlusion" ] 1 => array:2 [ "termino" => "ST" "descripcion" => "stent thrombosis" ] 2 => array:2 [ "termino" => "EES" "descripcion" => "everolimus-eluting stent" ] 3 => array:2 [ "termino" => "SES" "descripcion" => "sirolimus-eluting stent" ] 4 => array:2 [ "termino" => "DES" "descripcion" => "drug-eluting stent" ] 5 => array:2 [ "termino" => "BMS" "descripcion" => "bare-metal stent" ] ] ] ] ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1262 "Ancho" => 1568 "Tamanyo" => 137687 ] ] "descripcion" => array:1 [ "en" => "Incidence of definite and probable stent thrombosis at 12-month follow-up (overall rate 1.4%). EES: everolimus-eluting stent; SES: sirolimus-eluting stent; ST: stent thrombosis." ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "LVEF: left ventricular ejection fraction; MI: myocardial infarction; PAD: peripheral arterial disease; PCI: percutaneous coronary intervention." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No thrombosis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Thrombosis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67±6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64±10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.493 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Female (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Diabetes (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.555 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hypertension (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.553 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Hypercholesterolemia (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">71.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Smoking (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.256 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">PAD (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">LVEF (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48±8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53±13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.568 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Creatinine (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.8±0.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.0±0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.499 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Blood glucose (mg/dl) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">93±22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">120±50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.499 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Previous PCI (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.265 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Previous surgery (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Previous MI (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab726713.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Clinical characteristics of the study population." ] ] 2 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Thrombosis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No thrombosis \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Number of affected vessels \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1±0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.8±0.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.080 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Number of stents \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.7±0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.0±1.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.254 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Maximum stent diameter (mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.8±0.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.9±0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.438 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Stent length (mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59.7±19.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48.7±24.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.422 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Reference diameter (mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.7±0.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3.0±0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.694 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Minimal luminal diameter (mm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.3±0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.2±0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.002 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Post-procedural stenosis (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">42.8±13.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20.4±9.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top"><0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Post-procedural TIMI flow \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.7±0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.9±0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.288 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Balloon over-dilation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0±0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.3±0.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.313 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Multivessel disease (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.049 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Location anterior descending (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.037 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Bifurcation (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Radial approach (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Retrograde access (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top">Anticoagulant used (%)</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Sodium heparin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">82.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.438 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Bivalirudin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">11.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.322 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Enoxaparin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Time of occlusion >3 months (%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">79.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.495 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab726712.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Angiographic characteristics of the study population." ] ] 3 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "EES: everolimus-eluting stent; NSTEMI: non-ST-elevation myocardial infarction; SES: sirolimus-eluting stent." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">Type \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">Stent \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">Time \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">Presentation \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="char" valign="middle">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">Definite \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">SES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">24 hours \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">Angina \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="middle">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">Probable \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">SES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">9 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">NSTEMI \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="middle">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">Definite \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">SES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">117 days \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">NSTEMI \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="middle">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">Possible \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">EES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">8 month \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="middle">Sudden death \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab726714.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Characteristics and clinical presentation of patients with stent thrombosis." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:34 [ 0 => array:3 [ "identificador" => "bib0175" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Immediate results and one-year clinical outcome after percutaneous coronary interventions in chronic total occlusions: data from a multicenter, prospective, observational study (TOAST-GISE)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:4 [ 0 => "Z. Olivari" 1 => "P. Rubartelli" 2 => "F. Piscione" 3 => "TOAST-GISE Investigators" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2003" "volumen" => "4" "paginaInicial" => "1672" "paginaFinal" => "1678" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0180" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trends in outcomes after percutaneous coronary intervention for chronic total occlusion: a 25-year experience from the Mayo Clinic" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Prasad" 1 => "C.S. Rihal" 2 => "R.J. Lennon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2006.12.040" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2007" "volumen" => "49" "paginaInicial" => "1611" "paginaFinal" => "1618" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17433951" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0185" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Procedural outcomes and long-term survival among patients undergoing percutaneous coronary intervention of a chronic total occlusion in native coronary arteries: a 20-year experience" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.A. Suero" 1 => "S.P. Marso" 2 => "P.G. Jones" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2001" "volumen" => "38" "paginaInicial" => "409" "paginaFinal" => "414" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11499731" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0190" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Angiographic success and procedural complications in patients undergoing percutaneous coronary chronic total occlusion interventions: a weighted meta-analysis of 18,061 patients from 65 studies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "V.G. Patel" 1 => "K.M. Brayton" 2 => "A. Tamayo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcin.2012.10.011" "Revista" => array:6 [ "tituloSerie" => "JACC Cardiovasc Interv" "fecha" => "2013" "volumen" => "6" "paginaInicial" => "128" "paginaFinal" => "136" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23352817" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0195" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "I. Iakovou" 1 => "T. Schmidt" 2 => "E. Bonizzoni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.293.17.2126" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2005" "volumen" => "293" "paginaInicial" => "2126" "paginaFinal" => "2130" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15870416" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0200" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of coronary stent thrombosis: the Dutch Stent Thrombosis Registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.W. van Werkum" 1 => "A.A. Heestermans" 2 => "A.C. Zomer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2008.12.055" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2009" "volumen" => "53" "paginaInicial" => "1399" "paginaFinal" => "1409" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19371823" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0205" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P.K. Kuchulakanti" 1 => "W.W. Chu" 2 => "R. Torguson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.105.600155" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2006" "volumen" => "113" "paginaInicial" => "1108" "paginaFinal" => "1113" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16490815" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0210" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparisons of baseline demographics, clinical presentation, and long-term outcome among patients with early, late, and very late stent thrombosis of sirolimus-eluting stents: observations from the Registry of Stent Thrombosis for Review and Reevaluation (RESTART)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "T. Kimura" 1 => "T. Morimoto" 2 => "K. Kozuma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.110.976092" "Revista" => array:4 [ "tituloSerie" => "Circulation" "fecha" => "2010" "volumen" => "122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21147730" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0215" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized comparison of sirolimus-eluting and everolimus-eluting coronary stents in the treatment of total coronary occlusions: results from the chronic coronary occlusion treated by everolimus-eluting stent randomized trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Moreno" 1 => "E. García" 2 => "R. Teles" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCINTERVENTIONS.112.000076" "Revista" => array:6 [ "tituloSerie" => "Circ Cardiovasc Interv" "fecha" => "2013" "volumen" => "6" "paginaInicial" => "21" "paginaFinal" => "28" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23403384" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0220" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical end points in coronary stent trials: a case for standardized definitions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:4 [ 0 => "D.E. Cutlip" 1 => "S. Windecker" 2 => "R. Mehran" 3 => "Academic Research Consortium" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.106.685313" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2007" "volumen" => "115" "paginaInicial" => "2344" "paginaFinal" => "2351" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17470709" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0225" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Drug-eluting stent thrombosis: results from a pooled analysis including 10 randomized studies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Moreno" 1 => "C. Fernández" 2 => "R. Hernández" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2004.11.065" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2005" "volumen" => "45" "paginaInicial" => "954" "paginaFinal" => "959" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15766835" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0230" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stent thrombosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "D.R. Holmes Jr." 1 => "D.J. Kereiakes" 2 => "S. Garg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2010.07.016" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2010" "volumen" => "56" "paginaInicial" => "1357" "paginaFinal" => "1365" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20946992" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0235" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Virmani" 1 => "G. Guagliumi" 2 => "A. Farb" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/01.CIR.0000116202.41966.D4" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2004" "volumen" => "109" "paginaInicial" => "701" "paginaFinal" => "705" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14744976" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0240" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Histologic correlates of angiographic chronic total coronary artery occlusions: influence of occlusion duration on neovascular channel patterns and intimal plaque composition" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S.S. Srivatsa" 1 => "W.D. Edwards" 2 => "C.M. Boos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "1997" "volumen" => "29" "paginaInicial" => "955" "paginaFinal" => "963" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9120181" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0245" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natural history of experimental arterial chronic total occlusions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Jaffe" 1 => "G. Leung" 2 => "N.R. Munce" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2008.09.064" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2009" "volumen" => "53" "paginaInicial" => "1148" "paginaFinal" => "1158" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19324261" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0250" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of sirolimus-eluting and bare metal stent for treatment of patients with total coronary occlusions: results of the GISSOC II-GISE multicentre randomized trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P. Rubartelli" 1 => "A.S. Petronio" 2 => "V. Guiducci" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehq199" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2010" "volumen" => "31" "paginaInicial" => "2014" "paginaFinal" => "2020" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20566487" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0255" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of sirolimus-eluting stent on the outcome of patients with chronic total occlusions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Nakamura" 1 => "T.S. Muthusamy" 2 => "J.H. Bae" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.amjcard.2004.08.088" "Revista" => array:6 [ "tituloSerie" => "Am J Cardiol" "fecha" => "2005" "volumen" => "95" "paginaInicial" => "161" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15642545" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0260" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Immediate and mid-term outcomes of sirolimus-eluting stent implantation for chronic total occlusions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "L. Ge" 1 => "I. Iakovou" 2 => "J. Cosgrave" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehi191" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2005" "volumen" => "26" "paginaInicial" => "1056" "paginaFinal" => "1062" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15817605" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0265" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sirolimus-eluting stent in chronic total occlusion: the SICTO Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C. Lotan" 1 => "Y. Almagor" 2 => "K. Kuiper" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1540-8183.2006.00151.x" "Revista" => array:6 [ "tituloSerie" => "J Interv Cardiol" "fecha" => "2006" "volumen" => "19" "paginaInicial" => "307" "paginaFinal" => "312" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16881976" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0270" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Significant reduction in restenosis after the use of sirolimus-eluting stents in the treatment of chronic total occlusions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A. Hoye" 1 => "K. Tanabe" 2 => "P.A. Lemos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2004.01.045" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2004" "volumen" => "43" "paginaInicial" => "1954" "paginaFinal" => "1958" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15172397" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0275" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary Stenting of Totally Occluded Native Coronary Arteries II (PRISON II): a randomized comparison of bare metal stent implantation with sirolimus-eluting stent implantation for the treatment of total coronary occlusions" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.J. Suttorp" 1 => "G.J. Laarman" 2 => "B.M. Rahel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.106.613588" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2006" "volumen" => "114" "paginaInicial" => "921" "paginaFinal" => "928" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16908768" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0280" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A randomised comparison of an everolimus-eluting coronary stent with a paclitaxel-eluting coronary stent: the SPIRIT II trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P.W. Serruys" 1 => "P. Ruygrok" 2 => "J. Neuzner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "EuroIntervention" "fecha" => "2006" "volumen" => "2" "paginaInicial" => "286" "paginaFinal" => "294" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19755303" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0285" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized comparison of everolimus-eluting and paclitaxel-eluting stents: two-year clinical follow-up from the Clinical Evaluation of the Xience V Everolimus Eluting Coronary Stent System in the Treatment of Patients with de novo Native Coronary Artery Lesions (SPIRIT) III trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "G.W. Stone" 1 => "M. Midei" 2 => "W. Newman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.108.803528" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2009" "volumen" => "119" "paginaInicial" => "680" "paginaFinal" => "686" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19171853" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0290" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Everolimus-eluting versus paclitaxel-eluting stents in coronary artery disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "G.W. Stone" 1 => "A. Rizvi" 2 => "K. Sudhir" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa0910496" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2010" "volumen" => "362" "paginaInicial" => "1663" "paginaFinal" => "1674" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20445180" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0295" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Second-generation everolimus-eluting and paclitaxel-eluting stents in real-life practice (COMPARE): a randomised trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "E. Kedhi" 1 => "K.S. Joesoef" 2 => "E. McFadden" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(09)62127-9" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2010" "volumen" => "375" "paginaInicial" => "201" "paginaFinal" => "209" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20060578" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0300" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized comparison of the efficacy and safety of zotarolimus-eluting stents vs. sirolimus-eluting stents for percutaneous coronary intervention in chronic total occlusion-CAtholic Total Occlusion Study (CATOS) trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "H.J. Park" 1 => "H.Y. Kim" 2 => "J.M. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circ J" "fecha" => "2012" "volumen" => "76" "paginaInicial" => "868" "paginaFinal" => "875" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22277317" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0305" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Techniques and material used in the percutaneous treatment of chronic coronary occlusions. Data from the CIBELES study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Moreno" 1 => "E. García" 2 => "R. Teles" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.repc.2012.11.012" "Revista" => array:6 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2013" "volumen" => "32" "paginaInicial" => "593" "paginaFinal" => "599" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23896301" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0310" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incomplete stent apposition and very late stent thrombosis after drug-eluting stent implantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S. Cook" 1 => "P. Wenaweser" 2 => "M. Togni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.106.658237" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2007" "volumen" => "115" "paginaInicial" => "2426" "paginaFinal" => "2434" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17485593" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0315" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "K. Fujii" 1 => "S.G. Carlier" 2 => "G.S. Mintz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2004.12.066" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2005" "volumen" => "45" "paginaInicial" => "995" "paginaFinal" => "998" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15808753" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0320" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Angioscopic evaluation of neointima coverage: sirolimus drug-eluting stent versus bare metal stent" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Oyabu" 1 => "Y. Ueda" 2 => "N. Ogasawara" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ahj.2006.07.025" "Revista" => array:6 [ "tituloSerie" => "Am Heart J" "fecha" => "2006" "volumen" => "152" "paginaInicial" => "1168" "paginaFinal" => "1174" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17161071" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0325" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incomplete stent apposition and delayed tissue coverage are more frequent in drug-eluting stents implanted during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction than in drug-eluting stents implanted for stable/unstable angina: insights from optical coherence tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "N. Gonzalo" 1 => "P. Barlis" 2 => "P.W. Serruys" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Coll Cardiol Intv" "fecha" => "2009" "volumen" => "2" "paginaInicial" => "445" "paginaFinal" => "452" ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0330" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Everolimus-eluting stents for treatment of chronic total coronary occlusions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Wöhrle" 1 => "W. Rottbauer" 2 => "A. Imhof" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00392-011-0359-3" "Revista" => array:6 [ "tituloSerie" => "Clin Res Cardiol" "fecha" => "2012" "volumen" => "101" "paginaInicial" => "23" "paginaFinal" => "28" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21938564" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0335" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Short and long term comparison (24 months) of an alternative sirolimus-coated stent with bioabsorbable polymer and a bare metal stent of similar design in chronic coronary occlusions: the CORACTO trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "N. Reifart" 1 => "K.E. Hauptmann" 2 => "A. Rabe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4244/EIJV6I3A59" "Revista" => array:6 [ "tituloSerie" => "EuroIntervention" "fecha" => "2010" "volumen" => "6" "paginaInicial" => "356" "paginaFinal" => "360" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20884414" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0340" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term clinical outcome of chronic total occlusive lesions treated with drug-eluting stents: comparison of sirolimus-eluting and paclitaxel-eluting stents" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "S.P. Lee" 1 => "S.Y. Kim" 2 => "K.W. Park" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circ J" "fecha" => "2010" "volumen" => "74" "paginaInicial" => "693" "paginaFinal" => "700" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20197629" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003400000003/v2_201504010220/S2174204915000604/v2_201504010220/en/main.assets" "Apartado" => array:4 [ "identificador" => "9917" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003400000003/v2_201504010220/S2174204915000604/v2_201504010220/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000604?idApp=UINPBA00004E"]

Statistics

Original Article

Drug-eluting stent thrombosis in the treatment of chronic total coronary occlusions: Incidence, presentation and related factors. Data from the CIBELES trial

Trombose do stent fármaco ativo no tratamento da oclusões totais coronárias: incidência, apresentação e fatores relacionados. Os dados do ensaio Cibeles

Eduardo Arroyo-Úcara, Raul Morenoa,

Corresponding author

raulmorenog@hotmail.com

Corresponding author.

, Eulogio Garcíab, Rui Telesc, Jose-Ramon Rumorosod, Henrique Cyrne Carvalhoe, Francisco Javier Goicoleaf, José Moreug, Josefa Maurih, Manel Sabatéi, Vicente Mainarj, Lino Patriciok, Mariano Valdésl, Felipe Fernández-Vázquezm, Angel Sánchez-Recaldea, Guillermo Galeotea, Santiago Jimenez-Valeroa, Manuel Almeidac, Esteban López de Saa, Luis Calvoa..., Ignacio Plazaa, Jose-Luis Lopez-Sendóna, Jose-Luis R. Martínn, for the CIBELES investigators Ver más

a Hospital Universitario La Paz, Madrid, Spain

b Hospital Clinico, Madrid, Spain

c Hospital de Santa Cruz, Lisbon, Portugal

d Hospital de Galdakao, Bilbao, Spain

e Hospital de Santo Antonio, Porto, Portugal

f Hospital Puerta de Hierro, Majadahonda, Spain

g Hospital Virgen de la Salud, Toledo, Spain

h Hospital German Trias I Pujol, Badalona, Spain

i Hospital Santa Creu I Sant Pau, Barcelona, Spain

j Hospital General, Alicante, Spain

k Hospital de Santa Marta, Lisboa, Portugal

l Hospital Virgen de la Arrixaca, Murcia, Spain

m Complejo Hospitalario, León, Spain

n Research Manager, School of Biomedical and Health Sciences, Universidad Europea de Madrid, Spain

Read

5592

Times
was read the article

1583

Total PDF

4009

Total HTML

Share statistics

 array:23 [
  "pii" => "S2174204915000604"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2015.03.005"
  "estado" => "S300"
  "fechaPublicacion" => "2015-03-01"
  "aid" => "602"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2014"
  "documento" => "article"
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Cardiol. 2015;34:193-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2936
    "formatos" => array:3 [
      "EPUB" => 172
      "HTML" => 2300
      "PDF" => 464
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2174204915000525"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2014.10.003"
    "estado" => "S300"
    "fechaPublicacion" => "2015-03-01"
    "aid" => "600"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "ssu"
    "cita" => "Rev Port Cardiol. 2015;34:201-8"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5009
      "formatos" => array:3 [
        "EPUB" => 160
        "HTML" => 4005
        "PDF" => 844
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review article</span>"
      "titulo" => "Galectin-3&#44; a prognostic marker &#8211; and a therapeutic target&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "201"
          "paginaFinal" => "208"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Galectina-3&#58; indicador de progn&#243;stico&#46; Alvo de interven&#231;&#227;o terap&#234;utica&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1380
              "Ancho" => 1487
              "Tamanyo" => 95453
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Median galectin-3 levels among heart failure patients who died &#40;n&#61;17&#41; within 60 days and those who survived &#40;n&#61;192&#41;&#46; Results from the PRIDE subanalysis&#46; Reproduced with permission from van Kimmenade et al&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">3</span></a></p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ana Rita Pereira, Luiz Menezes Falc&#227;o"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Ana Rita"
              "apellidos" => "Pereira"
            ]
            1 => array:2 [
              "nombre" => "Luiz"
              "apellidos" => "Menezes Falc&#227;o"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S0870255115000359"
        "doi" => "10.1016/j.repc.2014.10.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255115000359?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000525?idApp=UINPBA00004E"
    "url" => "/21742049/0000003400000003/v2_201504010220/S2174204915000525/v2_201504010220/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2174204915000264"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2014.08.016"
    "estado" => "S300"
    "fechaPublicacion" => "2015-03-01"
    "aid" => "564"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2015;34:179-91"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4820
      "formatos" => array:3 [
        "EPUB" => 159
        "HTML" => 3586
        "PDF" => 1075
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Systematic review of cost-effectiveness analyses of novel oral anticoagulants for stroke prevention in atrial fibrillation"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "179"
          "paginaFinal" => "191"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Revis&#227;o sistem&#225;tica das an&#225;lises custo-efetividade dos novos anticoagulantes orais na preven&#231;&#227;o do acidente vascular cerebral na fibrilha&#231;&#227;o auricular&#58; estudo AFFORD"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 2885
              "Ancho" => 2987
              "Tamanyo" => 516426
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Graphical representation of the results of the AFFORD study&#44; showing incremental cost-effectiveness ratios &#40;ICER&#41; in euros per quality-adjusted life year &#40;QALY&#41; after currency conversion when necessary&#46; The vertical line represents the willingness-to-pay threshold of 30 000 euros per QALY adopted in Portugal&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Jo&#227;o Ferreira, Ana Mirco"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Jo&#227;o"
              "apellidos" => "Ferreira"
            ]
            1 => array:2 [
              "nombre" => "Ana"
              "apellidos" => "Mirco"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S0870255114003114"
        "doi" => "10.1016/j.repc.2014.08.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0870255114003114?idApp=UINPBA00004E"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000264?idApp=UINPBA00004E"
    "url" => "/21742049/0000003400000003/v2_201504010220/S2174204915000264/v2_201504010220/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Drug-eluting stent thrombosis in the treatment of chronic total coronary occlusions&#58; Incidence&#44; presentation and related factors&#46; Data from the CIBELES trial"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "193"
        "paginaFinal" => "199"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Eduardo Arroyo-&#218;car, Raul Moreno, Eulogio Garc&#237;a, Rui Teles, Jose-Ramon Rumoroso, Henrique Cyrne Carvalho, Francisco Javier Goicolea, Jos&#233; Moreu, Josefa Mauri, Manel Sabat&#233;, Vicente Mainar, Lino Patricio, Mariano Vald&#233;s, Felipe Fern&#225;ndez-V&#225;zquez, Angel S&#225;nchez-Recalde, Guillermo Galeote, Santiago Jimenez-Valero, Manuel Almeida, Esteban L&#243;pez de Sa, Luis Calvo, Ignacio Plaza, Jose-Luis Lopez-Send&#243;n, Jose-Luis R&#46; Mart&#237;n"
        "autores" => array:24 [
          0 => array:3 [
            "nombre" => "Eduardo"
            "apellidos" => "Arroyo-&#218;car"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:4 [
            "nombre" => "Raul"
            "apellidos" => "Moreno"
            "email" => array:1 [
              0 => "raulmorenog&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Eulogio"
            "apellidos" => "Garc&#237;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Rui"
            "apellidos" => "Teles"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Jose-Ramon"
            "apellidos" => "Rumoroso"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Henrique Cyrne"
            "apellidos" => "Carvalho"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Francisco Javier"
            "apellidos" => "Goicolea"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">f</span>"
                "identificador" => "aff0030"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Jos&#233;"
            "apellidos" => "Moreu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">g</span>"
                "identificador" => "aff0035"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Josefa"
            "apellidos" => "Mauri"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">h</span>"
                "identificador" => "aff0040"
              ]
            ]
          ]
          9 => array:3 [
            "nombre" => "Manel"
            "apellidos" => "Sabat&#233;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">i</span>"
                "identificador" => "aff0045"
              ]
            ]
          ]
          10 => array:3 [
            "nombre" => "Vicente"
            "apellidos" => "Mainar"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">j</span>"
                "identificador" => "aff0050"
              ]
            ]
          ]
          11 => array:3 [
            "nombre" => "Lino"
            "apellidos" => "Patricio"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">k</span>"
                "identificador" => "aff0055"
              ]
            ]
          ]
          12 => array:3 [
            "nombre" => "Mariano"
            "apellidos" => "Vald&#233;s"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">l</span>"
                "identificador" => "aff0060"
              ]
            ]
          ]
          13 => array:3 [
            "nombre" => "Felipe"
            "apellidos" => "Fern&#225;ndez-V&#225;zquez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">m</span>"
                "identificador" => "aff0065"
              ]
            ]
          ]
          14 => array:3 [
            "nombre" => "Angel"
            "apellidos" => "S&#225;nchez-Recalde"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          15 => array:3 [
            "nombre" => "Guillermo"
            "apellidos" => "Galeote"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          16 => array:3 [
            "nombre" => "Santiago"
            "apellidos" => "Jimenez-Valero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          17 => array:3 [
            "nombre" => "Manuel"
            "apellidos" => "Almeida"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          18 => array:3 [
            "nombre" => "Esteban"
            "apellidos" => "L&#243;pez de Sa"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          19 => array:3 [
            "nombre" => "Luis"
            "apellidos" => "Calvo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          20 => array:3 [
            "nombre" => "Ignacio"
            "apellidos" => "Plaza"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          21 => array:3 [
            "nombre" => "Jose-Luis"
            "apellidos" => "Lopez-Send&#243;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          22 => array:3 [
            "nombre" => "Jose-Luis R&#46;"
            "apellidos" => "Mart&#237;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">n</span>"
                "identificador" => "aff0070"
              ]
            ]
          ]
          23 => array:1 [
            "colaborador" => "for the CIBELES investigators"
          ]
        ]
        "afiliaciones" => array:14 [
          0 => array:3 [
            "entidad" => "Hospital Universitario La Paz&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Hospital Clinico&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Hospital de Santa Cruz&#44; Lisbon&#44; Portugal"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Hospital de Galdakao&#44; Bilbao&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Hospital de Santo Antonio&#44; Porto&#44; Portugal"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
          5 => array:3 [
            "entidad" => "Hospital Puerta de Hierro&#44; Majadahonda&#44; Spain"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
          6 => array:3 [
            "entidad" => "Hospital Virgen de la Salud&#44; Toledo&#44; Spain"
            "etiqueta" => "g"
            "identificador" => "aff0035"
          ]
          7 => array:3 [
            "entidad" => "Hospital German Trias I Pujol&#44; Badalona&#44; Spain"
            "etiqueta" => "h"
            "identificador" => "aff0040"
          ]
          8 => array:3 [
            "entidad" => "Hospital Santa Creu I Sant Pau&#44; Barcelona&#44; Spain"
            "etiqueta" => "i"
            "identificador" => "aff0045"
          ]
          9 => array:3 [
            "entidad" => "Hospital General&#44; Alicante&#44; Spain"
            "etiqueta" => "j"
            "identificador" => "aff0050"
          ]
          10 => array:3 [
            "entidad" => "Hospital de Santa Marta&#44; Lisboa&#44; Portugal"
            "etiqueta" => "k"
            "identificador" => "aff0055"
          ]
          11 => array:3 [
            "entidad" => "Hospital Virgen de la Arrixaca&#44; Murcia&#44; Spain"
            "etiqueta" => "l"
            "identificador" => "aff0060"
          ]
          12 => array:3 [
            "entidad" => "Complejo Hospitalario&#44; Le&#243;n&#44; Spain"
            "etiqueta" => "m"
            "identificador" => "aff0065"
          ]
          13 => array:3 [
            "entidad" => "Research Manager&#44; School of Biomedical and Health Sciences&#44; Universidad Europea de Madrid&#44; Spain"
            "etiqueta" => "n"
            "identificador" => "aff0070"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Trombose do <span class="elsevierStyleItalic">stent</span> f&#225;rmaco ativo no tratamento da oclus&#245;es totais coron&#225;rias&#58; incid&#234;ncia&#44; apresenta&#231;&#227;o e fatores relacionados&#46; Os dados do ensaio Cibeles"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1262
            "Ancho" => 1568
            "Tamanyo" => 137687
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Incidence of definite and probable stent thrombosis at 12-month follow-up &#40;overall rate 1&#46;4&#37;&#41;&#46; EES&#58; everolimus-eluting stent&#59; SES&#58; sirolimus-eluting stent&#59; ST&#58; stent thrombosis&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0035" class="elsevierStylePara elsevierViewall">Chronic total coronary occlusions &#40;CTO&#41; constitute one of the most complex and challenging therapeutic scenarios for an interventional cardiologist&#44; due not only to the technical complexity of the lesion and the need for specific operator skills&#44; but also to the many complications that can occur during and after the procedure&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">1&#8211;4</span></a> Stent thrombosis &#40;ST&#41; represents the most important clinical complication due to the high rate of death and&#47;or myocardial infarction&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">5</span></a> Its pathophysiology includes various factors related to the device itself&#44; the procedure and the patient&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">It has been traditionally considered that one the factors associated with increased risk of ST is&#44; as suggested by some studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">7&#44;8</span></a> the implantation of a drug-eluting stent &#40;DES&#41; in the context of a CTO&#46; The aim of this study is to assess the incidence&#44; clinical significance and timing of DES thrombosis in the treatment of CTO&#44; given the lack of clear knowledge concerning the safety of these devices in this context&#46; For this purpose&#44; data on ST from the CIBELES trial<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a> were studied&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Patients</span><p id="par0045" class="elsevierStylePara elsevierViewall">The CIBELES clinical trial &#40;ClinicalTrials&#46;gov number <a href="ctgov:NCT00793221">NCT00793221</a>&#41; included 207 patients with CTO of more than two weeks duration&#44; after successful balloon angioplasty&#46; These patients were randomized to receive an everolimus-eluting stent &#40;EES&#41; &#40;Xience V&#44; Abbott Vascular&#41; or a sirolimus-eluting stent &#40;SES&#41; &#40;Cypher&#44; Cordis&#41;&#46; The primary outcome was in-stent late loss&#46; Thirteen centers in Spain and Portugal were involved in this trial&#44; which was sponsored by the Spanish Society of Cardiology&#46; Abbott Vascular supported the study by an unconditional grant&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The antithrombotic therapy&#44; approach &#40;radial or femoral&#41; and material used during the procedure were chosen according to operator preferences or the established protocols of each center&#46; Angiographic follow-up was performed at nine months after revascularization&#46; In the event of significant restenosis&#44; repeat revascularization was performed&#44; if clinically indicated &#40;angina&#44; silent ischemia or presence of myocardial viability&#41; and technically feasible&#46; Quantitative coronary analysis was performed at an independent laboratory using MEDIS software &#40;Leiden&#44; The Netherlands&#41;&#46; The study was monitored by Chiltern International&#44; and featured an independent clinical events committee&#46; The clinical follow-up was performed over a period of 12 months after revascularization&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">This substudy assesses the incidence&#44; timing&#44; clinical presentation and independent predictors of ST in patients included in the CIBELES trial&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Definitions</span><p id="par0060" class="elsevierStylePara elsevierViewall">The definition of ST used was that of the Academic Research Consortium&#44;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">10</span></a> as follows&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#40;1&#41;</span><p id="par0065" class="elsevierStylePara elsevierViewall">definite thrombosis&#58; documented angiographically or by autopsy&#59;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#40;2&#41;</span><p id="par0070" class="elsevierStylePara elsevierViewall">probable thrombosis&#58; an acute coronary syndrome in the territory of the treated artery&#44; or either sudden cardiac or unexplained death in the 30 days after stent implantation&#59;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#40;3&#41;</span><p id="par0075" class="elsevierStylePara elsevierViewall">possible thrombosis&#58; sudden cardiac or unexplained death beyond 30 days after stent implantation&#46;</p></li></ul></p><p id="par0080" class="elsevierStylePara elsevierViewall">In view of these criteria&#44; of special interest for the study were the rates of definite or probable thrombosis&#46; From a chronological point of view&#44; thrombosis was considered as&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#40;1&#41;</span><p id="par0085" class="elsevierStylePara elsevierViewall">acute&#58; within 24 hours after stent implantation&#59;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#40;2&#41;</span><p id="par0090" class="elsevierStylePara elsevierViewall">sub-acute&#58; between the first 24 hours and the first 30 days after stent implantation&#59;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#40;3&#41;</span><p id="par0095" class="elsevierStylePara elsevierViewall">late&#58; beyond the first 30 days after stent implantation&#46;</p></li></ul></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Statistical analysis</span><p id="par0100" class="elsevierStylePara elsevierViewall">The collected data were analyzed using SPSS version 12&#46;0 for Windows &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#44; USA&#41;&#46; Qualitative variables were expressed as percentages&#44; and quantitative variables as mean &#177; standard deviation&#46; The chi-square test and Fisher&#39;s exact test were used to compare qualitative variables&#46; Multivariate analysis was performed using logistic regression analysis&#46; Comparison between quantitative variables was performed using the Student&#39;s t test&#46; A value of p&#60;0&#46;05 was considered statistically significant&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Incidence and clinical presentation of stent thrombosis</span><p id="par0105" class="elsevierStylePara elsevierViewall">The clinical and angiographic characteristics of the study population are summarized in <a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>&#46; During follow-up&#44; ST was diagnosed in three patients&#44; two definite &#40;1 and 117 days after the procedure&#41; and one probable &#40;nine days after the procedure&#41;&#46; The characteristics of these patients are summarized in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">The first patient was randomized to the SES group and received three stents&#46; However&#44; a paclitaxel-eluting stent was also implanted distally to the treated lesion&#46; Within 24 hours of the procedure the patient presented acute ST of the paclitaxel device&#46; Although there was no evidence of thrombosis of the SES&#44; this event was classified as definite ST as the design of the analysis was by intention to treat&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The second patient experienced a non-ST-elevation acute coronary syndrome nine days after the initial intervention&#46; This event was initially treated conservatively&#46; At the scheduled angiographic follow-up&#44; coronary angiography demonstrated total occlusion of the target vessel&#46; ST was considered the most likely cause of the event&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">A third patient had a definite ST&#44; 117 days after treatment&#46; This patient was admitted with a non-ST-elevation acute coronary syndrome&#59; angiography showed a thrombotic occlusion of the treated target vessel and PCI was subsequently repeated&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The overall rate of definite or probable thrombosis was therefore 1&#46;4&#37; &#40;0&#46;9&#37; early&#44; 0&#46;5&#37; late&#41;&#46; In no case did ST lead to death or Q-wave myocardial infarction&#46; The clinical presentation was non-Q-wave myocardial infarction in two cases and unstable angina in one&#46; There were also no documented cases of probable or definite ST in patients assigned to the EES group&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">A fourth patient had sudden death of unknown cause eight months after the coronary intervention&#46; ST was considered in this case as possible&#46; Thus&#44; the overall incidence of ST &#40;definite&#44; probable or possible&#41; was 1&#46;8&#37;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Factors related to stent thrombosis</span><p id="par0135" class="elsevierStylePara elsevierViewall">The univariate analysis &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41; revealed that patients with a higher incidence of ST were those who had single-vessel disease &#40;3&#46;3&#37; vs&#46; 0&#46;0&#37;&#44; p&#61;0&#46;049&#41;&#44; in whom the lesion was in the anterior descending artery &#40;3&#46;5&#37; vs&#46; 0&#46;0&#37;&#44; p&#61;0&#46;037&#41;&#44; and who showed a lower minimum luminal diameter &#40;1&#46;3&#177;0&#46;6 mm vs&#46; 2&#46;6&#177;0&#46;5 mm&#44; p&#60;0&#46;001&#41; immediately after the procedure&#46; Moreover&#44; the ST rate was 3&#46;0&#37; in the SES group compared to 0&#46;0&#37; in the EES group &#40;p&#61;0&#46;074&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; Multivariate analysis showed that the only independent predictor of ST in this context was minimal lumen diameter immediately after the procedure &#40;p&#61;0&#46;012&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0140" class="elsevierStylePara elsevierViewall">ST is an uncommon event&#44; with a variable clinical presentation but generally unfavorable course&#44; resulting in high rates of myocardial infarction &#40;50&#8211;70&#37;&#41; or death &#40;20&#8211;40&#37;&#41;&#46; The data in the literature on its incidence are inconsistent&#44; but it is estimated at between 0&#46;5&#37; and 2&#46;5&#37;&#46; These figures are slightly lower and with earlier clinical presentation for bare-metal stents &#40;BMS&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">9</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">The essential pathophysiology is closely related to various parameters and chronological stages&#58; early events often depend on variables associated with the procedure itself&#44; including the presence of residual thrombus&#44; dissection in the proximity of the target lesion&#44; stasis&#44; stent under-expansion&#44; stent length&#44; or a combination of the above&#46; Late events are most frequently associated with delayed scarring or incomplete and&#47;or inadequate neointimal covering&#46; Additionally&#44; underlying vascular inflammation and the length of the implanted devices have also been shown to be important&#44; with patients who had received longer stents or experienced an allergic reaction to the polymer most often suffering ST&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">11&#8211;13</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Traditionally&#44; percutaneous revascularization of a CTO is considered to be at high risk for ST&#46; This is due to the complexity of the procedure and the intricate histopathology of these lesions&#44; which contain varying amounts of collagen&#44; lipid&#44; calcifications and intraluminal microchannels&#46; All this leads to increased vulnerability and susceptibility to vascular damage&#46;<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">14&#44;15</span></a> Numerous clinical studies have demonstrated the superiority of DES &#40;mainly SES&#41; compared with BMS in the treatment of CTO&#44;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">16&#8211;21</span></a> with a lower restenosis rate and fewer major adverse cardiac events&#46; There are no data in the literature that conclusively demonstrate increased rates of ST in this context&#46; However&#44; ST is slightly more frequent in patients treated with first-generation DES&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The new generations of DES have been developed to improve safety and biocompatibility&#44; optimizing the three main components&#58; the platform&#44; the polymer and the drug&#46; They have been shown to be more effective than the first generation&#44; mainly due to a reduction in the rate of medium-term target vessel revascularization&#46; They have also shown a better safety profile&#44; with lower rates of ST&#46; These findings have been supported by the results of numerous clinical trials published in recent years &#40;SPIRIT II&#44;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">22</span></a> SPIRIT III&#44;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">23</span></a> SPIRIT IV&#44;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">24</span></a> COMPARE I<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">25</span></a>&#41;&#44; which compared the two generations of DES&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">So the results of the CIBELES trial&#44; which demonstrates the non-inferiority of EES versus SES&#44; should not surprise us&#46; They corroborate the previously published data and establish the safety of EES in the context of CTO&#46; Although it is not possible to draw definite conclusions concerning differences in ST between the two treatment groups&#44; there were no cases of definite or probable thrombosis in the EES arm&#46; Other second-generation stents&#44; such as zotarolimus-eluting stents&#44; have been proven to be at least as effective as SES in the treatment of CTO&#44; offering similar results in terms of numbers of ST&#46;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">26</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">As noted above&#44; ST usually presents as an acute event with a variable spectrum&#44; but usually with high rates of morbidity and mortality&#46; However&#44; in our study the clinical course was relatively benign&#44; presenting in all cases as an episode of unstable angina or a nonfatal non-ST-elevation myocardial infarction&#46; The particular angiographic scenario probably contributed significantly to this clinical course&#44; as pre-existing collateral circulation may have played a protective role in the event of an ischemic event caused by ST&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The data obtained suggest that the only independent predictor of ST is minimal luminal diameter immediately after the procedure&#46; This suggests that stents implanted in small vessels or malpositioned or under-expanded &#40;due to&#44; for example&#44; the existence of underlying calcium&#41; are at higher risk of thrombosis&#46; Recently published data emphasize the low use of non-compliant balloons in the treatment of CTO&#46; In the CIBELES trial&#44; post-dilatation was only performed in 25&#37; of patients&#44; a figure that is surprising given the expected proportion of malpositioning or under-expansion of the implanted stents according to the type and length of the treated lesions&#46; Invasive imaging techniques such as IVUS guided the procedure and its outcome in only 6&#37; of cases&#46;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">27</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">It is known that the same precipitating factors are predictors of ST after revascularization with DES in other coronary lesions&#46;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">28&#44;29</span></a> Analyzing the timing of the event rate&#44; there is no evidence of a clear grouping&#44; with one acute&#44; one subacute&#44; and one late ST in our study&#46; The two early events were presumably related to the procedure itself and associated local complications&#46; Stenting often leads to areas of dissection along the artery&#44; and together with the presence of organized thrombotic material&#44; areas of calcification and suboptimal end TIMI flow&#44; would provide the pathophysiological basis for increased incidence of ST&#46; However&#44; and despite the complexity of the procedure&#44; the frequency of acute and subacute ST is very low&#44; representing only 0&#46;97&#37; of all our cases&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Furthermore&#44; thrombosis associated with DES occurs later than with BMS&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">28</span></a> The main cause of this phenomenon is delayed endothelialization of the device&#44; caused by the antiproliferative action of the drug&#44; as indicated by various angioscopy&#44; optical coherence tomography and autopsy studies&#44; although no definite conclusions can be drawn&#46;<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">30&#44;31</span></a> We found only one case of late ST&#44; but the follow-up in our study was only 12 months after revascularization&#46; Hence&#44; possible very late thrombosis events were not recorded&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">In light of the above&#44; we consider that this substudy of the CIBELES trial shows that ST in the context of CTO treated with DES is an uncommon phenomenon&#44; similar to that of other coronary lesions&#46; The previously known predisposing factors account for the majority of the risk&#44; although the importance of certain local factors&#44; such as the frequent presence of underlying calcium or areas of arterial dissection&#44; should be borne in mind&#46; Our data are similar to those published by other groups&#44; in which the efficacy of EES<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">32</span></a> and other second-generation stents<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">33&#44;34</span></a> was assessed&#44; suggesting the existence of a class effect&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Moreover&#44; second-generation DES have tended to diminish ST and are probably better in this regard than the first generation&#46; The clinical presentation is in this context milder than in other circumstances&#44; as the abundant collateral circulation acts as insurance and protects possible at-risk myocardial territory&#46; Therefore&#44; and given the available scientific evidence&#44; we believe that DES stenting in CTO &#8211; and even more with second-generation stents &#8211; does not lead to added risk of ST&#44; and presents a clear benefit in restenosis rates&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">21</span></a> Invasive imaging techniques such as IVUS or optical coherence tomography&#44; and the use of non-compliant balloons after stent implantation&#44; are useful tools to predict and correct malpositioning or under-expansion&#44; thereby alleviating some of the main triggers of thrombosis&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Study limitations</span><p id="par0195" class="elsevierStylePara elsevierViewall">Our study has some limitations&#46; First&#44; the CIBELES trial was designed to compare stent restenosis with EES and SES&#44; and not to study ST&#46; However&#44; it is not really feasible to perform a specific clinical trial to assess ST in the context of CTO&#46; Secondly&#44; CTO were defined as those with estimated occlusion time &#62;2 weeks &#40;and not &#62;3 months as recommended in recent consensus documents&#41;&#46; The data are thus comparable to those of other trials of DES in CTO&#44; such as PRISON II&#46;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">21</span></a> In any case&#44; in our study the estimated duration of occlusion was not related to the rate of ST&#46; Thirdly&#44; since the choice of antiplatelet therapy was at the discretion of the operator&#44; there was no uniformity concerning the dose and type of drug administered&#46; Finally&#44; the clinical monitoring of patients was conducted over a 12-month period&#44; so events after this period were not recorded&#46; Consequently&#44; despite its low incidence&#44; possible very late ST is not included in this study&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conclusions</span><p id="par0200" class="elsevierStylePara elsevierViewall">The rate of thrombosis of DES in patients with CTO is low &#40;1&#46;4&#37;&#41;&#44; especially in those treated with EES compared to SES&#46; In this context&#44; the only independent predictor is minimal luminal diameter after the procedure&#46; The clinical presentation in all cases was relatively benign &#40;unstable angina or nonfatal non-ST-elevation myocardial infarction&#41;&#46; The use of DES in the treatment of CTO is a safe option and should not be considered to increase risk of thrombosis&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Ethical disclosures</span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Protection of human and animal subjects</span><p id="par0205" class="elsevierStylePara elsevierViewall">The authors declare that the procedures followed were in accordance with the regulations of the relevant clinical research ethics committee and with those of the Code of Ethics of the World Medical Association &#40;Declaration of Helsinki&#41;&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Confidentiality of data</span><p id="par0210" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Right to privacy and informed consent</span><p id="par0215" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article&#46; The corresponding author is in possession of this document&#46;</p></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflicts of interest</span><p id="par0220" class="elsevierStylePara elsevierViewall">This study was supported by the Spanish Society of Cardiology&#44; with an unrestricted grant by Abbott Vascular&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:13 [
        0 => array:3 [
          "identificador" => "xres469301"
          "titulo" => "Abstract"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Introduction and Objectives"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Methods"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Results"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec491912"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres469300"
          "titulo" => "Resumo"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Introdu&#231;&#227;o e objetivos"
            ]
            1 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "M&#233;todos"
            ]
            2 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Resultados"
            ]
            3 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Conclus&#245;es"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec491913"
          "titulo" => "Palavras-chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Patients"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Definitions"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Results"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Incidence and clinical presentation of stent thrombosis"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Factors related to stent thrombosis"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Study limitations"
        ]
        9 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conclusions"
        ]
        10 => array:3 [
          "identificador" => "sec0060"
          "titulo" => "Ethical disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0075"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        11 => array:2 [
          "identificador" => "sec0080"
          "titulo" => "Conflicts of interest"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2014-07-15"
    "fechaAceptado" => "2014-08-16"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec491912"
          "palabras" => array:5 [
            0 => "<span class="elsevierStyleItalic">Stent</span>"
            1 => "Thrombosis"
            2 => "<span class="elsevierStyleItalic">Everolimus</span>"
            3 => "<span class="elsevierStyleItalic">Sirolimus</span>"
            4 => "Chronic total coronary occlusion"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec491913"
          "palabras" => array:5 [
            0 => "<span class="elsevierStyleItalic">Stent</span>"
            1 => "Trombose"
            2 => "Everolimus"
            3 => "Sirolimus"
            4 => "Oclus&#227;o coron&#225;ria cr&#243;nica total"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to analyze the incidence of drug-eluting stent thrombosis &#40;sirolimus or everolimus&#41; in patients with chronic total coronary occlusions &#40;CTO&#41; and to determine its clinical implications and related factors&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Data from the 12-month follow-up of the 207 patients included in the CIBELES trial with CTO were analyzed&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Stent thrombosis occurred in three patients&#44; two definite and one probable &#40;overall thrombosis rate&#58; 1&#46;4&#37;&#41;&#46; However&#44; there were no cases of death or Q-wave myocardial infarction&#46; In univariate analysis&#44; patients with a higher incidence of stent thrombosis were those in whom the target vessel was the left anterior descending&#44; who had single-vessel disease&#44; were assigned to treatment with sirolimus-eluting stents&#44; and those with smaller minimum luminal diameter immediately after the procedure&#46; In multivariate analysis&#44; the only independent predictor of stent thrombosis was minimal luminal diameter immediately after the procedure&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The rate of drug-eluting stent thrombosis in patients with CTO is relatively low &#40;1&#46;4&#37;&#41;&#46; The only independent predictor of stent thrombosis in this context was minimal luminal diameter after the procedure and the clinical presentation was in all cases relatively benign&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction and Objectives"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusions"
          ]
        ]
      ]
      "pt" => array:3 [
        "titulo" => "Resumo"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introdu&#231;&#227;o e objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">o objetivo do nosso estudo foi analisar a incid&#234;ncia de trombose de <span class="elsevierStyleItalic">stent</span> com elui&#231;&#227;o de f&#225;rmaco &#40;<span class="elsevierStyleItalic">sirolimus</span> ou <span class="elsevierStyleItalic">everolimus</span>&#41; em pacientes com oclus&#245;es coron&#225;rias cr&#243;nicas e identificar as suas implica&#231;&#245;es cl&#237;nicas e fatores relacionados&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">12 meses de acompanhamento dos 207 pacientes inclu&#237;dos no ensaio Cibeles com oclus&#227;o total coron&#225;ria cr&#243;nica&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">a trombose de <span class="elsevierStyleItalic">stent</span> ocorreu em tr&#234;s doentes&#58; duas definitivas e uma prov&#225;vel &#40;taxa global de trombose 1&#44;4&#37;&#41;&#46; No entanto&#44; n&#227;o surgiu nenhum caso de morte ou enfarte do mioc&#225;rdio com onda Q&#46; Na an&#225;lise univariada&#44; os doentes com maior incid&#234;ncia de trombose de <span class="elsevierStyleItalic">stent</span> foram aqueles em que o vaso-alvo foi a descendente anterior&#44; os que tinham a doen&#231;a de um vaso&#44; os que foram considerados para tratamento com <span class="elsevierStyleItalic">stent</span> com <span class="elsevierStyleItalic">sirolimus</span>&#44; e aqueles com di&#226;metro luminal m&#237;nimo menor imediatamente ap&#243;s o procedimento&#46; Na an&#225;lise multivariada&#44; o &#250;nico preditor independente de trombose do <span class="elsevierStyleItalic">stent</span> foi o di&#226;metro luminal m&#237;nimo imediatamente ap&#243;s o procedimento&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">a taxa de trombose de <span class="elsevierStyleItalic">stent</span> farmacol&#243;gico em pacientes com oclus&#227;o coron&#225;ria cr&#243;nica foi relativamente baixa &#40;1&#44;4&#37;&#41;&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">O &#250;nico preditor independente de trombose de <span class="elsevierStyleItalic">stent</span> neste contexto foi o di&#226;metro luminal m&#237;nimo ap&#243;s o procedimento&#44; tendo a apresenta&#231;&#227;o cl&#237;nica em todos os casos sido relativamente benigna&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introdu&#231;&#227;o e objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclus&#245;es"
          ]
        ]
      ]
    ]
    "nomenclatura" => array:1 [
      0 => array:3 [
        "identificador" => "nom0005"
        "titulo" => "<span class="elsevierStyleSectionTitle" id="sect0065">List of abbreviations</span>"
        "listaDefinicion" => array:1 [
          0 => array:1 [
            "definicion" => array:6 [
              0 => array:2 [
                "termino" => "CTO"
                "descripcion" => "<p id="par0005" class="elsevierStylePara elsevierViewall">chronic total occlusion</p>"
              ]
              1 => array:2 [
                "termino" => "ST"
                "descripcion" => "<p id="par0010" class="elsevierStylePara elsevierViewall">stent thrombosis</p>"
              ]
              2 => array:2 [
                "termino" => "EES"
                "descripcion" => "<p id="par0015" class="elsevierStylePara elsevierViewall">everolimus-eluting stent</p>"
              ]
              3 => array:2 [
                "termino" => "SES"
                "descripcion" => "<p id="par0020" class="elsevierStylePara elsevierViewall">sirolimus-eluting stent</p>"
              ]
              4 => array:2 [
                "termino" => "DES"
                "descripcion" => "<p id="par0025" class="elsevierStylePara elsevierViewall">drug-eluting stent</p>"
              ]
              5 => array:2 [
                "termino" => "BMS"
                "descripcion" => "<p id="par0030" class="elsevierStylePara elsevierViewall">bare-metal stent</p>"
              ]
            ]
          ]
        ]
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1262
            "Ancho" => 1568
            "Tamanyo" => 137687
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Incidence of definite and probable stent thrombosis at 12-month follow-up &#40;overall rate 1&#46;4&#37;&#41;&#46; EES&#58; everolimus-eluting stent&#59; SES&#58; sirolimus-eluting stent&#59; ST&#58; stent thrombosis&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">LVEF&#58; left ventricular ejection fraction&#59; MI&#58; myocardial infarction&#59; PAD&#58; peripheral arterial disease&#59; PCI&#58; percutaneous coronary intervention&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No thrombosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Thrombosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#177;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64&#177;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;493&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Female &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Diabetes &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;555&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hypertension &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;553&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hypercholesterolemia &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Smoking &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;256&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">PAD &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">LVEF &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#177;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53&#177;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;568&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Creatinine &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;8&#177;0&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;0&#177;0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;499&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Blood glucose &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">93&#177;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">120&#177;50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;499&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Previous PCI &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;265&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Previous surgery &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Previous MI &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab726713.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Clinical characteristics of the study population&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Thrombosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No thrombosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Number of affected vessels</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#177;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;8&#177;0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;080&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Number of stents</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;7&#177;0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;0&#177;1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;254&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Maximum stent diameter &#40;mm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;8&#177;0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;9&#177;0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;438&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Stent length &#40;mm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#46;7&#177;19&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;7&#177;24&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;422&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Reference diameter &#40;mm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;7&#177;0&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#46;0&#177;0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;694&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Minimal luminal diameter &#40;mm&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;3&#177;0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;2&#177;0&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Post-procedural stenosis &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&#46;8&#177;13&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;4&#177;9&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#60;0&#46;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Post-procedural TIMI flow</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;7&#177;0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;9&#177;0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;288&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Balloon over-dilation</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;0&#177;0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;3&#177;0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;313&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Multivessel disease &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">56&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;049&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Location anterior descending &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;037&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Bifurcation &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Radial approach &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Retrograde access &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Anticoagulant used &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sodium heparin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;438&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bivalirudin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;322&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Enoxaparin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Time of occlusion &#62;3 months &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;495&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab726712.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Angiographic characteristics of the study population&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">EES&#58; everolimus-eluting stent&#59; NSTEMI&#58; non-ST-elevation myocardial infarction&#59; SES&#58; sirolimus-eluting stent&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">Type&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">Stent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">Time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="middle" scope="col" style="border-bottom: 2px solid black">Presentation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="middle">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">Definite&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">SES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">24 hours&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">Angina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="middle">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">Probable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">SES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">9 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">NSTEMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="middle">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">Definite&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">SES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">117 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">NSTEMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="middle">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">Possible&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">EES&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">8 month&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="middle">Sudden death&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab726714.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Characteristics and clinical presentation of patients with stent thrombosis&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:34 [
            0 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immediate results and one-year clinical outcome after percutaneous coronary interventions in chronic total occlusions&#58; data from a multicenter&#44; prospective&#44; observational study &#40;TOAST-GISE&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:4 [
                            0 => "Z&#46; Olivari"
                            1 => "P&#46; Rubartelli"
                            2 => "F&#46; Piscione"
                            3 => "TOAST-GISE Investigators"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2003"
                        "volumen" => "4"
                        "paginaInicial" => "1672"
                        "paginaFinal" => "1678"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Trends in outcomes after percutaneous coronary intervention for chronic total occlusion&#58; a 25-year experience from the Mayo Clinic"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Prasad"
                            1 => "C&#46;S&#46; Rihal"
                            2 => "R&#46;J&#46; Lennon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2006.12.040"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2007"
                        "volumen" => "49"
                        "paginaInicial" => "1611"
                        "paginaFinal" => "1618"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17433951"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Procedural outcomes and long-term survival among patients undergoing percutaneous coronary intervention of a chronic total occlusion in native coronary arteries&#58; a 20-year experience"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;A&#46; Suero"
                            1 => "S&#46;P&#46; Marso"
                            2 => "P&#46;G&#46; Jones"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2001"
                        "volumen" => "38"
                        "paginaInicial" => "409"
                        "paginaFinal" => "414"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11499731"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Angiographic success and procedural complications in patients undergoing percutaneous coronary chronic total occlusion interventions&#58; a weighted meta-analysis of 18&#44;061 patients from 65 studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "V&#46;G&#46; Patel"
                            1 => "K&#46;M&#46; Brayton"
                            2 => "A&#46; Tamayo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcin.2012.10.011"
                      "Revista" => array:6 [
                        "tituloSerie" => "JACC Cardiovasc Interv"
                        "fecha" => "2013"
                        "volumen" => "6"
                        "paginaInicial" => "128"
                        "paginaFinal" => "136"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23352817"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidence&#44; predictors&#44; and outcome of thrombosis after successful implantation of drug-eluting stents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "I&#46; Iakovou"
                            1 => "T&#46; Schmidt"
                            2 => "E&#46; Bonizzoni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.293.17.2126"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2005"
                        "volumen" => "293"
                        "paginaInicial" => "2126"
                        "paginaFinal" => "2130"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15870416"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Predictors of coronary stent thrombosis&#58; the Dutch Stent Thrombosis Registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;W&#46; van Werkum"
                            1 => "A&#46;A&#46; Heestermans"
                            2 => "A&#46;C&#46; Zomer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2008.12.055"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2009"
                        "volumen" => "53"
                        "paginaInicial" => "1399"
                        "paginaFinal" => "1409"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19371823"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;K&#46; Kuchulakanti"
                            1 => "W&#46;W&#46; Chu"
                            2 => "R&#46; Torguson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.105.600155"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2006"
                        "volumen" => "113"
                        "paginaInicial" => "1108"
                        "paginaFinal" => "1113"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16490815"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparisons of baseline demographics&#44; clinical presentation&#44; and long-term outcome among patients with early&#44; late&#44; and very late stent thrombosis of sirolimus-eluting stents&#58; observations from the Registry of Stent Thrombosis for Review and Reevaluation &#40;RESTART&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "T&#46; Kimura"
                            1 => "T&#46; Morimoto"
                            2 => "K&#46; Kozuma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.110.976092"
                      "Revista" => array:4 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2010"
                        "volumen" => "122"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21147730"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomized comparison of sirolimus-eluting and everolimus-eluting coronary stents in the treatment of total coronary occlusions&#58; results from the chronic coronary occlusion treated by everolimus-eluting stent randomized trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Moreno"
                            1 => "E&#46; Garc&#237;a"
                            2 => "R&#46; Teles"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCINTERVENTIONS.112.000076"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ Cardiovasc Interv"
                        "fecha" => "2013"
                        "volumen" => "6"
                        "paginaInicial" => "21"
                        "paginaFinal" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23403384"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical end points in coronary stent trials&#58; a case for standardized definitions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:4 [
                            0 => "D&#46;E&#46; Cutlip"
                            1 => "S&#46; Windecker"
                            2 => "R&#46; Mehran"
                            3 => "Academic Research Consortium"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.106.685313"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2007"
                        "volumen" => "115"
                        "paginaInicial" => "2344"
                        "paginaFinal" => "2351"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17470709"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Drug-eluting stent thrombosis&#58; results from a pooled analysis including 10 randomized studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Moreno"
                            1 => "C&#46; Fern&#225;ndez"
                            2 => "R&#46; Hern&#225;ndez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2004.11.065"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2005"
                        "volumen" => "45"
                        "paginaInicial" => "954"
                        "paginaFinal" => "959"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15766835"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stent thrombosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46;R&#46; Holmes Jr&#46;"
                            1 => "D&#46;J&#46; Kereiakes"
                            2 => "S&#46; Garg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2010.07.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2010"
                        "volumen" => "56"
                        "paginaInicial" => "1357"
                        "paginaFinal" => "1365"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20946992"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Virmani"
                            1 => "G&#46; Guagliumi"
                            2 => "A&#46; Farb"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.CIR.0000116202.41966.D4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2004"
                        "volumen" => "109"
                        "paginaInicial" => "701"
                        "paginaFinal" => "705"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14744976"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histologic correlates of angiographic chronic total coronary artery occlusions&#58; influence of occlusion duration on neovascular channel patterns and intimal plaque composition"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;S&#46; Srivatsa"
                            1 => "W&#46;D&#46; Edwards"
                            2 => "C&#46;M&#46; Boos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "1997"
                        "volumen" => "29"
                        "paginaInicial" => "955"
                        "paginaFinal" => "963"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9120181"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Natural history of experimental arterial chronic total occlusions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Jaffe"
                            1 => "G&#46; Leung"
                            2 => "N&#46;R&#46; Munce"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2008.09.064"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2009"
                        "volumen" => "53"
                        "paginaInicial" => "1148"
                        "paginaFinal" => "1158"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19324261"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of sirolimus-eluting and bare metal stent for treatment of patients with total coronary occlusions&#58; results of the GISSOC II-GISE multicentre randomized trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46; Rubartelli"
                            1 => "A&#46;S&#46; Petronio"
                            2 => "V&#46; Guiducci"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehq199"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2010"
                        "volumen" => "31"
                        "paginaInicial" => "2014"
                        "paginaFinal" => "2020"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20566487"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Impact of sirolimus-eluting stent on the outcome of patients with chronic total occlusions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Nakamura"
                            1 => "T&#46;S&#46; Muthusamy"
                            2 => "J&#46;H&#46; Bae"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjcard.2004.08.088"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2005"
                        "volumen" => "95"
                        "paginaInicial" => "161"
                        "paginaFinal" => "166"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15642545"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immediate and mid-term outcomes of sirolimus-eluting stent implantation for chronic total occlusions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "L&#46; Ge"
                            1 => "I&#46; Iakovou"
                            2 => "J&#46; Cosgrave"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehi191"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2005"
                        "volumen" => "26"
                        "paginaInicial" => "1056"
                        "paginaFinal" => "1062"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15817605"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sirolimus-eluting stent in chronic total occlusion&#58; the SICTO Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Lotan"
                            1 => "Y&#46; Almagor"
                            2 => "K&#46; Kuiper"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1540-8183.2006.00151.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Interv Cardiol"
                        "fecha" => "2006"
                        "volumen" => "19"
                        "paginaInicial" => "307"
                        "paginaFinal" => "312"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16881976"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Significant reduction in restenosis after the use of sirolimus-eluting stents in the treatment of chronic total occlusions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46; Hoye"
                            1 => "K&#46; Tanabe"
                            2 => "P&#46;A&#46; Lemos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2004.01.045"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2004"
                        "volumen" => "43"
                        "paginaInicial" => "1954"
                        "paginaFinal" => "1958"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15172397"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Primary Stenting of Totally Occluded Native Coronary Arteries II &#40;PRISON II&#41;&#58; a randomized comparison of bare metal stent implantation with sirolimus-eluting stent implantation for the treatment of total coronary occlusions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;J&#46; Suttorp"
                            1 => "G&#46;J&#46; Laarman"
                            2 => "B&#46;M&#46; Rahel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.106.613588"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2006"
                        "volumen" => "114"
                        "paginaInicial" => "921"
                        "paginaFinal" => "928"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16908768"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A randomised comparison of an everolimus-eluting coronary stent with a paclitaxel-eluting coronary stent&#58; the SPIRIT II trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46;W&#46; Serruys"
                            1 => "P&#46; Ruygrok"
                            2 => "J&#46; Neuzner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "EuroIntervention"
                        "fecha" => "2006"
                        "volumen" => "2"
                        "paginaInicial" => "286"
                        "paginaFinal" => "294"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19755303"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomized comparison of everolimus-eluting and paclitaxel-eluting stents&#58; two-year clinical follow-up from the Clinical Evaluation of the Xience V Everolimus Eluting Coronary Stent System in the Treatment of Patients with de novo Native Coronary Artery Lesions &#40;SPIRIT&#41; III trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46;W&#46; Stone"
                            1 => "M&#46; Midei"
                            2 => "W&#46; Newman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.108.803528"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2009"
                        "volumen" => "119"
                        "paginaInicial" => "680"
                        "paginaFinal" => "686"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19171853"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Everolimus-eluting versus paclitaxel-eluting stents in coronary artery disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "G&#46;W&#46; Stone"
                            1 => "A&#46; Rizvi"
                            2 => "K&#46; Sudhir"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa0910496"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2010"
                        "volumen" => "362"
                        "paginaInicial" => "1663"
                        "paginaFinal" => "1674"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20445180"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Second-generation everolimus-eluting and paclitaxel-eluting stents in real-life practice &#40;COMPARE&#41;&#58; a randomised trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Kedhi"
                            1 => "K&#46;S&#46; Joesoef"
                            2 => "E&#46; McFadden"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(09)62127-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2010"
                        "volumen" => "375"
                        "paginaInicial" => "201"
                        "paginaFinal" => "209"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20060578"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomized comparison of the efficacy and safety of zotarolimus-eluting stents vs&#46; sirolimus-eluting stents for percutaneous coronary intervention in chronic total occlusion-CAtholic Total Occlusion Study &#40;CATOS&#41; trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "H&#46;J&#46; Park"
                            1 => "H&#46;Y&#46; Kim"
                            2 => "J&#46;M&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ J"
                        "fecha" => "2012"
                        "volumen" => "76"
                        "paginaInicial" => "868"
                        "paginaFinal" => "875"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22277317"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Techniques and material used in the percutaneous treatment of chronic coronary occlusions&#46; Data from the CIBELES study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Moreno"
                            1 => "E&#46; Garc&#237;a"
                            2 => "R&#46; Teles"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.repc.2012.11.012"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2013"
                        "volumen" => "32"
                        "paginaInicial" => "593"
                        "paginaFinal" => "599"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23896301"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incomplete stent apposition and very late stent thrombosis after drug-eluting stent implantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Cook"
                            1 => "P&#46; Wenaweser"
                            2 => "M&#46; Togni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.106.658237"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2007"
                        "volumen" => "115"
                        "paginaInicial" => "2426"
                        "paginaFinal" => "2434"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17485593"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation&#58; an intravascular ultrasound study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "K&#46; Fujii"
                            1 => "S&#46;G&#46; Carlier"
                            2 => "G&#46;S&#46; Mintz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2004.12.066"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2005"
                        "volumen" => "45"
                        "paginaInicial" => "995"
                        "paginaFinal" => "998"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15808753"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Angioscopic evaluation of neointima coverage&#58; sirolimus drug-eluting stent versus bare metal stent"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Oyabu"
                            1 => "Y&#46; Ueda"
                            2 => "N&#46; Ogasawara"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ahj.2006.07.025"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Heart J"
                        "fecha" => "2006"
                        "volumen" => "152"
                        "paginaInicial" => "1168"
                        "paginaFinal" => "1174"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17161071"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incomplete stent apposition and delayed tissue coverage are more frequent in drug-eluting stents implanted during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction than in drug-eluting stents implanted for stable&#47;unstable angina&#58; insights from optical coherence tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Gonzalo"
                            1 => "P&#46; Barlis"
                            2 => "P&#46;W&#46; Serruys"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Coll Cardiol Intv"
                        "fecha" => "2009"
                        "volumen" => "2"
                        "paginaInicial" => "445"
                        "paginaFinal" => "452"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Everolimus-eluting stents for treatment of chronic total coronary occlusions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; W&#246;hrle"
                            1 => "W&#46; Rottbauer"
                            2 => "A&#46; Imhof"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00392-011-0359-3"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Res Cardiol"
                        "fecha" => "2012"
                        "volumen" => "101"
                        "paginaInicial" => "23"
                        "paginaFinal" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21938564"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short and long term comparison &#40;24 months&#41; of an alternative sirolimus-coated stent with bioabsorbable polymer and a bare metal stent of similar design in chronic coronary occlusions&#58; the CORACTO trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Reifart"
                            1 => "K&#46;E&#46; Hauptmann"
                            2 => "A&#46; Rabe"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4244/EIJV6I3A59"
                      "Revista" => array:6 [
                        "tituloSerie" => "EuroIntervention"
                        "fecha" => "2010"
                        "volumen" => "6"
                        "paginaInicial" => "356"
                        "paginaFinal" => "360"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20884414"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term clinical outcome of chronic total occlusive lesions treated with drug-eluting stents&#58; comparison of sirolimus-eluting and paclitaxel-eluting stents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46;P&#46; Lee"
                            1 => "S&#46;Y&#46; Kim"
                            2 => "K&#46;W&#46; Park"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circ J"
                        "fecha" => "2010"
                        "volumen" => "74"
                        "paginaInicial" => "693"
                        "paginaFinal" => "700"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20197629"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003400000003/v2_201504010220/S2174204915000604/v2_201504010220/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9917"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003400000003/v2_201504010220/S2174204915000604/v2_201504010220/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204915000604?idApp=UINPBA00004E"
]

Article information

ISSN: 21742049
Original language: English

DOI:10.1016/j.repce.2015.03.005

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	9	5	14
2024 October	36	23	59
2024 September	41	21	62
2024 August	51	29	80
2024 July	30	27	57
2024 June	32	17	49
2024 May	45	16	61
2024 April	37	21	58
2024 March	43	19	62
2024 February	71	20	91
2024 January	40	21	61
2023 December	27	20	47
2023 November	25	28	53
2023 October	22	14	36
2023 September	28	17	45
2023 August	23	12	35
2023 July	21	11	32
2023 June	15	8	23
2023 May	45	28	73
2023 April	28	3	31
2023 March	23	18	41
2023 February	24	23	47
2023 January	22	13	35
2022 December	31	17	48
2022 November	29	21	50
2022 October	30	20	50
2022 September	28	23	51
2022 August	24	32	56
2022 July	32	34	66
2022 June	17	12	29
2022 May	28	33	61
2022 April	25	26	51
2022 March	25	37	62
2022 February	35	26	61
2022 January	57	27	84
2021 December	27	32	59
2021 November	27	39	66
2021 October	31	37	68
2021 September	13	27	40
2021 August	27	27	54
2021 July	20	36	56
2021 June	21	21	42
2021 May	23	31	54
2021 April	31	33	64
2021 March	59	15	74
2021 February	37	10	47
2021 January	23	13	36
2020 December	34	11	45
2020 November	25	7	32
2020 October	15	7	22
2020 September	28	6	34
2020 August	24	7	31
2020 July	32	6	38
2020 June	23	4	27
2020 May	32	4	36
2020 April	23	7	30
2020 March	30	12	42
2020 February	112	37	149
2020 January	21	9	30
2019 December	29	2	31
2019 November	24	10	34
2019 October	24	4	28
2019 September	30	10	40
2019 August	30	4	34
2019 July	31	10	41
2019 June	42	15	57
2019 May	44	5	49
2019 April	25	20	45
2019 March	105	7	112
2019 February	103	8	111
2019 January	51	9	60
2018 December	42	9	51
2018 November	131	14	145
2018 October	302	20	322
2018 September	54	11	65
2018 August	20	4	24
2018 July	20	6	26
2018 June	26	5	31
2018 May	31	9	40
2018 April	35	2	37
2018 March	31	15	46
2018 February	24	2	26
2018 January	11	4	15
2017 December	35	0	35
2017 November	25	10	35
2017 October	35	12	47
2017 September	28	4	32
2017 August	30	13	43
2017 July	23	15	38
2017 June	38	8	46
2017 May	41	11	52
2017 April	22	6	28
2017 March	33	7	40
2017 February	20	4	24
2017 January	27	4	31
2016 December	36	7	43
2016 November	20	2	22
2016 October	25	3	28
2016 September	27	2	29
2016 August	3	1	4
2016 July	10	1	11
2016 June	6	2	8
2016 May	12	7	19
2016 April	15	1	16
2016 March	30	7	37
2016 February	36	11	47
2016 January	33	10	43
2015 December	35	5	40
2015 November	42	7	49
2015 October	31	6	37
2015 September	30	5	35
2015 August	41	14	55
2015 July	22	6	28
2015 June	25	7	32
2015 May	29	5	34
2015 April	42	15	57

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter