Boston Scientific has received approval to update the indications section of the Promus PREMIER Directions for Use to include the treatment of patients presenting with coronary artery ostial lesions, unprotected left main coronary artery lesions, coronary artery total occlusion lesions, in-stent restenosis in coronary artery lesions and coronary bifurcation lesions.
With its overexpansion capability2, excellent radial force3 and exceptional conformability3, Promus PREMIER™ Stent system is a great option for Total Occlusion and for Unprotected Left Main Coronary Artery Lesions.
Thanks to large cell diameters in the body of the stent to accommodate side branch access4, the PtCr Customized Stent Architecture and exceptional conformability3, Promus PREMIER is the optimal stent for Coronary Bifurcation Lesions.
Added recommendations include: For treatment of occluded vessels, contrast visualization of the distal vessel to confirm position of guidewire within the lumen is recommended. For in stent restenosis, where details of the original stent are known, the expanded inner diameter of the new stent should not exceed the dilation limits of the original stent. Where details of the original stent are not known, the expanded inner diameter of the new stent should not exceed the reference vessel diameter. When treating Bifurcations, care must be exercised to access the secondary vessel via the repeating geometry in the body of the stent within the primary vessel.
* The updated Directions for Use will also include an update on the current “Pre-and Post-Procedure Antiplatelet Regimen”:
In selected higher risk patients where the physician determines that the risks outweigh the benefits of continued DAPT, it may be reasonable to interrupt or discontinue therapy after 1 month based on low stent thrombosis rates and no observed increased risk for stent thrombosis as shown in the current literature. Patients who require premature discontinuation of antiplatelet therapy should be monitored closely and have their antiplatelet therapy restarted as soon as possible per the discretion of their treating physicians.