Open AccessClinical and angiographic follow‐up after long versus short stenting in unselected chronic coronary occlusions
Author(s) -
Choi SiWan,
Lee Cheol Whan,
Hong MyeongKi,
Lee JaeHwan,
Kim JaeJoong,
Park SeongWook,
Park SeungJung
Publication year - 2003
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4950260605
Subject(s) - medicine , restenosis , odds ratio , stent , confidence interval , cardiology , lesion , revascularization , myocardial infarction , retrospective cohort study , lumen (anatomy) , occlusion , coronary artery disease , radiology , surgery
Background : Few data are available on the efficacy of long stenting for lesions in unselected chronic total occlusion (CTO). Hypothesis : The study was undertaken to evaluate the angiographic restenosis and long‐term clinical outcomes after long stent implantation in patients with CTO. Methods : Our retrospective analysis includes a consecutive series of stent implantation in 220 patients with CTO. We compared angiographic restenosis, target lesion revascularization, and long‐term clinical outcomes of short stenting (< 20 mm, Group 1, n = 113) with a concurrent series of long stenting (≥ 20 mm, Group 2, n = 107). Results: Angiographic follow‐up was obtained in 174 patients (79.5% of those eligible), and the rates of angiographic restenosis were 19.3% in Group 1 and 33.7% in Group 2 (p < 0.05). In multivariate analysis, the postinterventional minimal lumen diameter was the only independent predictor of restenosis (odds ratio = 0.20, 95% confidence interval 0.08‐0.49, p < 0.01). The angiographic restenosis rate was significantly lower in Group 1 than in Group 2 in patients with final minimal lumen diameter < 3.0 mm (28.9 vs. 55.9%, respectively, p < 0.05). However, the angiographic restenosis rate was not significantly different between the two groups in patients with final minimal lumen diameter ≥ 3 mm (12.0 vs. 19.2%, respectively, p = NS). During the follow‐up (29.1 ± 10.8 months), there was no difference between the two groups in death, nonfatal myocardial infarction, and target lesion revascularization. Conclusions : The use of long (≥20 mm) versus short (< 20 mm) stents in patients with CTO is associated with a higher angiographic restenosis rate, but there is an equivalent risk of restenosis in selected patients with relatively large‐sized vessels.