EuroPCR 2021 | CASTLE: Orsiro vs Xience Guided by Intravascular Imaging

According to the CASTLE trial, the Orsino stent—a biodegradable, ultrathin, sirolimus-eluting stent—provides the same results at 12 months as Xience in angioplasty guided by intravascular imaging. This research was presented at the virtual EuroPCR 2021 Congress.

EuroPCR 2021 | CASTLE: Orsiro vs Xience guiados por imágenes intravasculares

Previous studies (BIOSTEMI and BIOFLOW V) showed that Orsiro was superior to Xience in reducing target-lesion revascularization. However, the reason behind this difference was unknown. Was it the thinner struts? The drug? The polymer?

This study sought to explain said outcomes by eliminating differences in implantation technique. Thus, “matching” was performed using intravascular imaging to guide angioplasty.

It should be noted that CASTLE was conducted in Japan, where optical coherence tomography (OCT) and intravascular ultrasound (IVUS) are used almost routinely.

Between 2019 and 2020, 1440 patients were randomized to undergo angioplasty with Orsiro vs. Xience stents. Ninety-eight percent of angioplasties were guided by intravascular imaging.

The composite endpoint of cardiovascular death, vessel infarction, and clinically justified lesion revascularization at 12 months was 5% for Orsiro vs. 4.9% for Xience (both below the expected thresholds).


Read also: EuroPCR 2021 | EBC MAIN: Provisional Stenting vs. Systematic Dual Stenting in Left Main Coronary Artery.


Though preliminary—only 70% of population underwent follow-up—, these results meet the criteria for non-inferiority.

Final results will be available shortly, and follow-up is set up to continue for 24 and 36 months.

Original Title: A randomised study comparing imaging guided implantation of Orsiro and Xience – CASTLE study.

Reference: Nakamura M. et al. Presentado en el congreso EuroPCR 2021.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

Coronary Artery Disease in Aortic Stenosis: CABG + SAVR vs. TAVR + PCI: Data from Spanish Centers

Multiple randomized studies have shown comparable or superior efficacy of transcatheter aortic valve replacement (TAVR) vs. coronary artery bypass graft (CABG).  However, many of...

Evolution of Small Balloon-Expandable Valves

Small aortic rings (20 mm) have posed a significant challenge for both surgery and transcatheter aortic valve implantation (TAVI) due to their association with an...

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 – ECLIPSE: Randomized Study of Orbital Atherectomy vs Conventional PCI in Severely Calcified Lesions

Coronary calcification is associated with stent under-expansion and increased risk of both early and late adverse events. Atherectomy is an essential tool for uncrossable...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

Severe Tricuspid Regurgitation: Surgical vs. Transcatheter Edge-to-Edge Repair

While highly prevalent, tricuspid regurgitation is a notably undertreated valvulopathy. Its progression has been associated with higher mortality and significant disability. According to the...

ACCESS-TAVI: Comparing Post TAVR Vascular Closure Devices

Transcatheter aortic valve replacement (TAVR) is a well-established option to treat elderly patients with severe symptomatic aortic valve stenosis. Technical advances and device development...

Endovascular Treatment of Iliofemoral Disease for the Improvement of Heart Failure with Preserved Ejection Fraction

Peripheral artery disease (PAD) is a significant risk factor in the development of difficult-to-treat conditions, such as heart failure with preserved ejection fraction (HFpEF)....