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Heart, Lung and Circulation S2032009;18S:S1–S286 Abstracts

within 42 days of stent implantation (42.4% versus 12.8%beyond 42 days, p < 0.001), especially in patients revascu-larised following an acute coronary syndrome (65% versus32%, p = 0.037). There were no temporal differences in out-comes between the drug-eluting and bare metal stentgroups.

Interpretation: Patients undergoing non-cardiacsurgery after recent coronary stent implantation are atincreased risk of peri-operative myocardial ischaemia,myocardial infarction and death, particularly followingan acute coronary syndrome. For at least 2 years afterpercutaneous coronary intervention, cardiac outcomesfollowing non-cardiac surgery are similar for bothdrug-eluting and bare metal stents.

doi:10.1016/j.hlc.2009.05.503

458CAROTID ARTERY STENTING: A 12-YEAR SINGLECENTRE EXPERIENCE

David Roy, David Muller, David Baron, Paul Roy

St Vincent’s Hospital Campus, Sydney, Australia

Background: Previous randomised trials comparingcarotid artery stenting (CAS) and endarterectomy havereported stroke rates of 5.5–7.7% in the CAS arm. Multi-centre registries from high volume centres have reportedsignificantly lower complication rates.

Methods: Retrospective analysis of all carotid stentingprocedures at St. Vincent’s campus. The incidences ofstroke, death, and myocardial infarction (MI) at 30 days,and death or ipsilateral stroke between 31 days and 1 yearwere recorded.

Results: From 1997 to 2009, 323 procedures were per-formed on 297 patients, 51.2% of whom were symptomatic.Follow up was obtained in 257 (86.5%). The majority werehigh risk; 66.5% were NASCET ineligible. Distal protec-tion (DP) was used in 74.6% overall, and 97.1% from 2002.Stents were successfully placed in 319 of 322 arteries (99%).

At 30 days, 4 patients (1.6%) had an ipsilateral stroke, 7(2.5%) had a non-ipsilateral stroke, and 0.7% had an MI.Since DP became routine, 2 patients (1.0%) had an ipsi-lateral stroke, and 4 (2.7%) had a non-ipsilateral stroke at30 days. Of the 250 patients followed to 1 year, one addi-tional patient had an ipsilateral stroke, and 7 (2.7%) died,of which 5 were non-neurological deaths. The total strokerate at 1 year (including all strokes to 30 days, and ipsilat-eral strokes to 1 year) was 4.4% overall; 5.7% without DPand 4.2% where DP was used.

Conclusion: These results indicate that CAS is a safe andeffective procedure when performed in an experiencedcentre. It has rates of stroke, MI and death that comparefavourably with previously published randomised con-trolled trials.

doi:10.1016/j.hlc.2009.05.504

459CHANGING NATIONAL TRENDS IN THE USE OFDRUG-ELUTING STENTS IN AUSTRALIAN PRIVATEHOSPITALS: BALANCE AT LAST?

D. Eccleston 1, D. Clark 1, T. Rafter 2, S. Worthley 3, P.Sage 3, G. Holt 2, M. Horrigan 1, for the Heart Care GroupInvestigators

1 Warringal Private Hospital, Melbourne, Australia2 Wesley Hospital Brisbane, Australia3 Wakefield Hospital Adelaide, Australia

Background: Drug-eluting stent (DES) use in Australianprivate hospitals enjoyed initial enthusiasm due to theireffectiveness in reducing restenosis, followed by a reduc-tion in use following reports of late DES thrombosis (LST)in 2006. We aimed to assess the current utilisation of DESin private hospitals across the nation to assess whether fur-ther data clarifying a low rate of DES thrombosis as wellas intense scrutiny of the literature regarding the benefitsof DES have altered DES usage.

Methods: We compared quarterly DES use as a percent-age of the total number of stents deployed between Juneto September 2006 (n = 1179), October 2007 to January 2008(n = 1179) and November 2008 to February 2009 (n = 165)across four Australian private hospitals. Fisher’s exact test(two-tailed) and Chi-square were used to assess the datafor significant change.

Results:Interval p-Value

June–September 06

October07–January 08

November08–February 09

% DES use 81.1* 69.8 64.8* <0.0001*

69.8 64.8 0.20

∗ p for 2006 vs. 2009.

Conclusion: The initial enthusiasm for DES wastempered by concerns regarding possible late stent throm-bosis. DES use has not increased again despite furtherdata demonstrating low rates of LST, and the emergenceof newer DES platforms. DES usage may have plateaueddue to clearer recognition of the most appropriate balancebetween risk and benefit.

doi:10.1016/j.hlc.2009.05.505

460CLINICAL EVALUATION OF EVEROLIMUS ELUTINGSTENT (XIENCE V) IN A HIGH RISK PATIENT POPU-LATION

Charles T. Itty, Ahmad Farshid, Paul Marley, Ian Jeffery,Darryl McGill, Simon O’Connor, Ren Tan

Department of Cardiology, The Canberra Hospital, Canberra,ACT, Australia

Background: Recent randomised trials have shown thatpatients who received Xience V Everolimus eluting stents(EES) had improved event free survival compared to baremetal (BMS) and Paclitaxel eluting stents. The efficacy and