Procedural results and outcomes after extensive stent coverage with drug-eluting stent implantation in single coronary lesions.
Longer stent length has remained associated with the incidence of major adverse cardiac events (MACEs) in the drug-eluting stent (DES) era; therefore, we aimed to determine clinical outcomes after extensive stent coverage with DES implantations in single coronary lesions. We evaluated the data from 99 consecutive patients treated with extensive DES coverage, defined as > or = 50 mm (mean 63.3 +/- 13.2, range 50 to 115), and a concurrent series of 466 patients with < or = 24-mm DES length (mean 18.4 +/- 3.8, range 8 to 24). The periprocedural, 1-, and 6-month outcomes were compared between the 2 groups. The baseline characteristics were mostly comparable between the 2 groups, and procedural and in-hospital outcomes were similar. Although the incidence of death and myocardial infarction at follow-up were comparable, the combined end points of target lesion revascularization plus MACEs at 6 months occurred more often with extensive stent coverage. Multivariate analysis revealed stent length to be the only independent predictor of target lesion revascularization plus MACEs. Patients treated with extensive DES coverage had similar procedural success, major in-hospital complications, and death and myocardial infarction at follow-up, but had more combined adverse events because of an overall higher target lesion revascularization rate.
Mishra
Sundeep
S
Division of Cardiology, Washington Hospital Center, Washington, DC, USA.
Wolfram
Roswitha M
RM
Torguson
Rebecca
R
Xue
Zhenyi
Z
Gevorkian
Natalie
N
Chu
William W
WW
Satler
Lowell F
LF
Pichard
Augusto D
AD
Suddath
William O
WO
Kent
Kenneth M
KM
Waksman
Ron
R
D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible