Primary Stenting for Coronary Artery Lesions 15Ð18 mm in Length: A Preliminary Experience with the Long (18 mm) Palmaz-Schatz Stent.
BACKGROUND: Currently little data exists on the use of single intracoronary stents for the treatment of long coronary artery lesions. The aim of this study was to evaluate the 18 mm Palmaz-Schatz stent (PS no. 204C) for the primary treatment of native coronary lesions between 15 mm and 18 mm in length. METHODS: A consecutive group of 17 patients were included in this study over a 3 month period. Each patient selected was felt suitable for elective treatment with an intracoronary stent and had a coronary artery lesion of >15 mm in length. Coronary arteriograms recorded just before PTCA, after full stent deployment and electively at 4 months after stent deployment were analyzed using semi-quantitative coronary angiography. RESULTS: Mean lesion length treated was 16.9 mm. The primary success rate for stent delivery was 16 out of 17 lesions. One patient required immediate coronary artery bypass surgery for extensive dissection of the right coronary artery. There were no out of hospital complications and no patient suffered acute or subacute stent thrombosis. All patients had an improvement in their Canadian Cardiovascular Angina Class: Three patients (21%) had asymptomatic restenosis (stenosis 50%) at follow-up angiography. CONCLUSION: This study shows the 18mm Palmaz-Schatz stent is relatively successful for the elective treatment of long coronary artery stenoses. Although the mean lesion length of 16.9 mm in this study is significantly greater than that of the BENESTENT and STRESS studies, the 21% restenosis rate is comparable.
Robinson
NM
Senior Registrar, Department of Cardiology, London Chest Hospital, Bonner Road, London, England, E2 9JX.
Wainwright
RJ