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Overlapping vs. one long stenting in long coronary lesions
Author(s) -
Lee Sang Hak,
Jang Yangsoo,
Oh Sung Jin,
Park Kyeong Jin,
Moon Yong Sun,
Min Ja Won,
Yang Joo Young,
Jang Gil Jin
Publication year - 2004
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20091
Subject(s) - medicine , restenosis , stent , dissection (medical) , cardiology , percutaneous coronary intervention , coronary stent , radiology , surgery , myocardial infarction
Intervention of long coronary lesions remains problematic, and optimal treatment strategy is yet to be determined. Despite advancement of stent technology, data are few regarding the efficacy of overlapping stents vs. a single long stent in long coronary lesions. This study was performed to evaluate the results of those strategies for long coronary lesions and to determine the predictors of in‐stent restenosis (ISR). Sixty‐four lesions (> 20 mm) in 64 patients were treated with either one long stent (group 1, n = 32) or two overlapping stents (group 2, n = 32). Overlapping stents were used at tortuous or calcified lesions and at lesions with diameter discrepancy or significant dissection. Immediate results, follow‐up clinical and angiographic outcomes, and predictors of ISR were evaluated. Procedures were successful in all patients in both groups. Clinical and angiographic follow‐ups were performed in 54 (84%) cases and 50 (78%) cases, respectively. During the follow‐up, major adverse cardiac event occurred in 36% of group 1 and 29% of group 2 ( P = 0.56). Six‐month ISR rates were 39% in group 1 and 41% in group 2 ( P = 0.91). Age (≥ 65 years old) was an independent risk factor of ISR (54% vs. 23%; OR = 4.4; P = 0.04), and distal reference diameter (RD) of less than 2.5 mm tended to predict ISR in multivariate analysis (60% vs. 25%; OR = 3.5; P = 0.06). In conclusion, stent overlapping can be used with outcome similar to that of one long stent in long coronary lesions. The optimal result may be obtained by considering the patient's age and the distal vessel diameter of the lesion. Catheter Cardiovasc Interv 2004; 62:298–302. © 2004 Wiley‐Liss, Inc.