title: Clinical outcomes after heterogeneous overlap stenting with drug-eluting stents and bare-metal stents for de novo coronary artery narrowings.
abstract: When it is difficult to deliver multiple drug-eluting stents (DES) or when size constraints limit DES implantation, bare-metal stents (BMS) may be implanted contiguous to DES. However, the clinical outcomes after overlapping DES and BMS implantation are not known. From September 2004 to June 2006, 4,872 consecutive patients who underwent percutaneous coronary intervention consented to be enrolled in a prospective registry. Of these patients, 44 (0.9%) with de novo lesions were treated with DES and BMS overlap stenting. All patients were followed to 12 months for the assessment of clinical outcomes. The average implanted stent diameter was 2.68 +/- 0.30 mm for DES and 2.35 +/- 0.38 mm for BMS. Overlapping BMS were implanted distal to DES in all but 1 case. One patient (2.3%) experienced acute stent thrombosis and died 2 days after the procedure. No other patient died or had a myocardial infarction during 12 months. The target vessel revascularization rate at 12 months, however, was 31.8%, mainly driven by diffuse in-stent restenosis in the BMS segments. In conclusion, the incidence of DES and BMS overlap stenting is rare in daily practice, but this procedure is associated with a high rate of target vessel revascularization.
authors.affiliation: Center for Interventional Vascular Therapy, Columbia University Medical Center, New York, NY, USA.
authors.forename: Jiro
authors.initials: J
authors.lastname: Aoki
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
authors.forename: George D
authors.initials: GD
authors.lastname: Dangas
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Lansky
authors.forename: Andy
authors.initials: A
authors.lastname: Morales
authors.forename: Masashi
authors.initials: M
authors.lastname: Kimura
authors.forename: Young-Hak
authors.initials: YH
authors.lastname: Kim
authors.forename: Issam
authors.initials: I
authors.lastname: Moussa
authors.forename: Giora
authors.initials: G
authors.lastname: Weisz
authors.forename: Edward M
authors.initials: EM
authors.lastname: Kreps
authors.forename: Michael
authors.initials: M
authors.lastname: Collins
authors.forename: Theresa
authors.initials: T
authors.lastname: Frankin-Bond
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Moses
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000453:epidemiology; D023921:Coronary Stenosis / Q000628:therapy*; D003328:Coronary Thrombosis / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D017239:Paclitaxel / Q000008:administration & dosage; D011446:Prospective Studies; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents; D016896:Treatment Outcome
chemical_list: D017239:Paclitaxel; D020123:Sirolimus