Influence of stent length to lesion length ratio on angiographic and clinical outcomes after implantation of bare metal and drug-eluting stents (the TAXUS-IV Study).
Longer bare metal stent lengths have been associated with greater restenosis. However, the effect of the ratio of stent length to lesion length on clinical and angiographic restenosis after implantation of bare metal and drug-eluting stents has not been clearly defined. Patients in the TAXUS-IV study who underwent single-study stent placement were categorized into tertiles based on ratios of stent length to lesion length. Clinical results at 1 year and angiographic outcomes at 9 months were compared across the 3 groups. The median ratios of stent length to lesion length were 1.20, 1.58, and 2.27 in the 3 tertiles. Analysis segment restenosis rates at 9 months were similar across the 3 tertiles with bare metal stents (24.7% vs 26.7% vs 23.8%, respectively, p = 0.90 for trend) and paclitaxel-eluting stents (11.7% vs 6.5% vs 5.4%, respectively, p = 0.24). Similarly, there were no differences in 1-year rates of target lesion revascularization across the 3 tertiles for bare metal stents (14.6% vs 14.8% vs 13.7%, respectively, p = 0.91) or paclitaxel-eluting stents (6.1% vs 3.6% vs 4.0%, respectively, p = 0.38). By multivariate analysis, the ratio of stent length to lesion length was an independent predictor of neither 9-month angiographic restenosis nor 1-year target lesion revascularization in the bare metal stent arm (odds ratio 1.21, p = 0.36, and hazard ratio 0.80, p = 0.31, respectively) or in the paclitaxel-eluting stent arm (odds ratio 0.86, p = 0.76, and hazard ratio 0.58, p = 0.21, respectively). These data do not support the arbitrary use of larger ratios of stent length to lesion length in patients who undergo implantation of drug-eluting stents.
Wong
S Chiu
SC
Weill Medical College of Cornell University, New York, New York 10021, USA. scwong@med.cornell.edu
Hong
Mun K
MK
Ellis
Stephen G
SG
Buchbinder
Maurice
M
Reisman
Mark
M
DeLago
Augustin
A
Kellett
Mirle
M
Popma
Jeffrey J
JJ
Russell
Mary E
ME
Mehran
Roxana
R
Moses
Jeffrey W
JW
Stone
Gregg W
GW
D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000517:prevention & control*; D016503:Drug Delivery Systems; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome
D017239:Paclitaxel