Clinical outcome of stent implantation in small coronary arteries using different types of coronary stents.
OBJECTIVE
We evaluated the results of stent placement in small coronary arteries.


METHODS
The subjects were divided into 2 groups: the first contained 911 lesions treated with stenting in the coronary arteries (stent group), and the second contained 1,203 background- and patient-matched lesions treated with balloon angioplasty (POBA group). There was no significant difference in the background of patients or lesions between the groups. A "small coronary artery" was defined as a coronary artery with a reference vessel diameter < 3.0 mm.


RESULTS
There was no significant difference in incidence of acute myocardial infarction (AMI), coronary artery bypass grafting, or death between the groups. In the stent group, acute occlusion (0.8%) and subacute thrombosis (2.1%) occurred. The restenosis rate of 29.8% in the stent group was significantly lower than in the POBA group (38.2%; p < 0.01). The restenosis rate of 19.4% in stented vessels 3.0 mm diameter was significantly lower than in vessels < 3.0 mm diameter (29.8%; p < 0.01). The rate of restenosis was 22.9% for the Multi-Link stent, 24.4% for the NIR stent, 34.1% for the GFX stent, and 35.3% for the PS stent. The restenosis rate of 23.8% in stented vessels > 2.5 mm diameter and < or = 20 mm length was significantly lower than in vessels , < or = 2.5 mm diameter and > 20 mm length (32.7%; p < 0.01). Factors associated with restenosis, analyzed using a stepwise multivariate logistic regression model, included ostial lesions and post-procedural minimum lumen diameter.


CONCLUSIONS
Stent implantation in vessels < 3.0 mm diameter using a newly designed coronary stent yielded favorable clinical results, while there was a high prevalence of restenosis, leading to diffused stenotic lesions, in vessels < 2.5 mm diameter.
Muramatsu
T
T
Division of Cardiology, Kawasaki Social Insurance Hospital, Kanagawa, Japan.
Tsukahara
R
R
Ho
M
M
Ito
Y
Y
Ishimori
H
H
Hirano
K
K
Nakano
M
M
Matsushita
M
M
Leung
W Y
WY
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects; D023921:Coronary Stenosis; D005260:Female; D006801:Humans; D008297:Male; D009204:Myocardial Revascularization / Q000295:instrumentation*; D012008:Recurrence; D012189:Retrospective Studies; D013223:Statistics as Topic; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome