Impact of overlapping drug-eluting stents in patients undergoing percutaneous coronary intervention.
BACKGROUND
Sirolimus-eluting stent (SES) implantation for the treatment of single coronary lesions is proven to be effective and durable. However, the safety and efficacy of overlapping SES for the treatment of long lesions have not been well established.


OBJECTIVE
We conducted a retrospective analysis to compare the clinical outcomes of overlapping versus nonoverlapping SES.


METHODS
Fifty-five patients who received overlapping SES were compared with 39 patients who received nonoverlapping SES.


RESULTS
The baseline clinical and angiographic characteristics were balanced between the two study groups. The in-hospital complications were similar between groups, except that non-Q-wave myocardial infarction was significantly higher in the Overlapping SES group when compared with the Nonoverlapping SES group (23.6% vs. 7.7%, P = 0.04). This higher rate of myonecrosis is due to periprocedural side branch compromises, including side branch narrowing, occlusion, and flow reduction. At 30 days and 6 months follow-up, all clinical outcomes were similar between the study groups. In addition, the event-free survival rate was similar between groups (P = 0.87).


CONCLUSIONS
The implantation of overlapping SES for the treatment of long, native coronary lesions is feasible and effective but is associated with an increased rate of periprocedural myonecrosis. This phenomenon is caused primarily by side branch compromises, but does not have any adverse impact on late clinical events.
Division of Cardiology, Washington Hospital Center, Washington, District of Columbia 20010, USA.
William W
WW
Chu
Pramod K
PK
Kuchulakanti
Rebecca
R
Torguson
Betty
B
Wang
Leonardo C
LC
Clavijo
William O
WO
Suddath
Augusto D
AD
Pichard
Lowell F
LF
Satler
Kenneth M
KM
Kent
Ron
R
Waksman
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D020123:Sirolimus