Sirolimus-eluting 1481

Paclitaxel-eluting 1407

Total 2888

On-label characteristics for use of a drug eluting stent

0

Use of only one stent irrespective of length with nominal diameters ranging from 2.5 to 3.5 mm in de novo lesions in native vessels and none of the off-label lesion or patients characteristics below

74

64

138

Off-label characteristics for use of a drug eluting stent

1

Use of stent in a re-stenotic previously stent-treated lesion [8] - [18]

25

48

75

2

Use of stent in a vein graft. This combines and replaces: “degenerated vein grafts with friable lesions” (C-lesion, Table 6 in [5] ) and “use of stent in bypass grafts” be it arteries or veins [7] - [18]

10

13

25

3

Use of stent in the left main coronary artery [6] - [8] [10] - [12] [14] - [19] . Irrespective of it is being protected by a previously performed CABG or by a fine arterialized collateral or whether it seems to be unprotected

14

20

37

4

Use of stent within 5 mm from the ostium [6] - [8] [10] [12] [15] [16] LAD2, LAD3, CX2, CX3, RCA2, RCA3 have no ostium

257

243

509

5

Use of stent in bifurcation lesion [6] [7] [9] - [19] (i.e. a lesion where a balloon has been inflated in each of the branches of the bifurcation)

125

124

272

6

Use of stent in an occlusion excepting acute myocardial infarctions treated acutely. This combines and replaces “use of stent in total occlusions more than 3 months old and/or bridging collaterals” (C-lesion, Table 6 in [5] ) and “use of stent in a chronic total occlusion” [9] - [12] [14] - [18]

114

145

272

7

Use of nominal stent diameter < 2.5 mm―our own definition which replaces use of stent in reference vessel diameter < 2.5 mm [6] [7] [10] [13] [15] - [18]

128

119

257

8

Use of more than one stent in the same lesion, which replaces use of stent in lesion lengths > 26 mm [16] , >28 mm [7] , >30 mm [6] [8] [10] [11] [15] [18] or >36 mm [19] and at least 2 overlapping stents [7] [8] [16]

260

265

558

9

Use of stent length > 20 mm, a high risk lesion (C-lesion, Table 6 in [5] )

518

454

1025

10

Use of stent in angulated lesion, a high risk lesion (C-lesion, Table 6 in [5] )―in this context > 45 degrees as was our own definition prior to publication of guideline [5] which defined > 90 degrees

277

254

535

11

Use of stent in vessel with severe proximal tortuousity, a high risk lesion (C-lesion, Table 6 in [5] )―replaces the “use of stent in a tortuous vessel (>60 degrees) in the region of the obstruction or proximal to the lesion” [6] [7]

289

245

538

12

Use of stent in lesions with visible thrombus at lesion site [6] [7] or distal to lesion

95

89

187

13

Inability to protect major side branches, a high risk lesion (C-lesion, Table 6 in [5] ), here defined as side branch > 1 mm in reference diameter

324

305

631

Patient characteristics for off-label use of stent

14

Use of stent in patients with STEMI [6] - [9] [11] - [14] [16] - [19] in an acute/emergency setting

205

185

422

15

Use of stent in patients with non-STEMI [9] [11] or unstable angina in a sub-acute/urgent setting which replaces: “use of stent in patients with acute coronary syndromes” [18] and “use of stent in patients with a recent AMI where there is evidence of thrombus or poor flow” [6] [7]

531

462

1049

16

Use of stents in more than one lesion [19] which also encompass use of stent in patients with multi-vessel disease [9] [14] [17] [18]

669

602

1385

17

Use of stent in patients with diabetes [11] [14]

248

234

509

Of special interest―although not an off-label characteristic

18

Use of DES in female gender

364

308

716

Not included in the present analysis due to absent data

19

Use of stent in patients with left ventricular ejection fraction < 0.30 [12] (or <0.25 [19] )

“not available”

“not available”

“not available”