Stented segment length as an independent predictor of restenosis.
OBJECTIVE
We sought to evaluate the relation between stented segment length and restenosis.


BACKGROUND
Multiple or long coronary stents are now being implanted in long lesions or in tandem lesions. A longer stented segment might result in a higher probability of restenosis. However, there is little information available on the relation between stented segment length and restenosis.


METHODS
Between April 1995 and December 1996, 725 patients with 1,090 lesions underwent stenting. Lesions were divided into three groups according to the length of the stented segment: 1) group I (n = 565): stented segment length < or =20 mm; 2) group II (n = 278): stented segment length >20 but < or =35 mm; and 3) group III (n = 247): stented segment length >35 mm.


RESULTS
There was no significant difference in the incidence of subacute stent thrombosis among the three groups (0.4% in group I, 0.4% in group II, 1.2% in group III; p = NS). The minimal lumen diameter (MLD) after stenting was greater in group I than in group III (3.04 +/- 0.60 mm in group I, 3.01 +/- 0.54 mm in group II, 2.91 +/- 0.58 mm in group III; p < 0.05). At follow up, a smaller MLD was observed in group III as compared with group I and group II (2.04 +/- 0.93 mm in group I, 1.92 +/- 1.00 mm in group II, 1.47 +/- 0.97 mm in group III; p < 0.01). The restenosis rates were 23.9% in group I, 34.6% in group II and 47.2% in group III (p < 0.01). Using multivariate analysis, the longer stented segment, the angiographic reference vessel diameter and the percent diameter stenosis after stenting were independent predictors of restenosis.


CONCLUSIONS
The present study shows that a longer stented segment is an independent predictor of restenosis without an influence on the risk of subacute thrombosis.
Kobayashi
Y
Y
Centro Cuore Columbus, Milan, Italy.
De Gregorio
J
J
Kobayashi
N
N
Akiyama
T
T
Reimers
B
B
Finci
L
L
Di Mario
C
C
Colombo
A
A
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D015607:Stents / Q000706:statistics & numerical data; D018084:Ultrasonography, Interventional / Q000379:methods / Q000706:statistics & numerical data