title: Cobalt-chromium stents in long lesions of large vessels: clinical and angiographic results.
abstract: Although drug-eluting stents have reduced the restenosis rate, some patients are not good candidates for prolonged double-antiplatelet therapy. Our goal was to learn the results of implanting cobalt-chromium stents in long lesions of large vessels.All consecutive patients with ≥1 lesion treated with a cobalt-chromium stent ≥28 mm in length and ≥3.5 mm in diameter during a 12-month period in 2 centers were monitored clinically and angiographically to determine the clinical status, restenosis rate, pattern of restenosis, and need for revascularization.The series comprised 78 patients with 81 lesions, mean age, 62.6 ± 15.2 yr; diabetes mellitus,19.2%; and primary or rescue intervention, 20.6%. Target vessels were the left anterior descending coronary artery, 12 (14.8%); left circumflex coronary artery, 12 (14.8%); and right coronary artery, 57 (70.4%). The mean lesion length was 35.18 ± 12.65 mm. The proximal reference diameter after percutaneous coronary intervention was 3.64 ± 0.54 mm; the distal, 3.2 ± 0.43 mm; and the mean, 3.42 ± 0.44 mm. The mean stent length was 38.05 ± 12.78 mm (range, 28-90 mm). The binary restenosis rate was 23% (15/64), with pattern IB in 2 cases, IC in 5, II in 7, and IV in 1. Revascularization was needed in 6 patients.In treating long lesions of large vessels, we found that cobalt-chromium stents achieved a moderate rate of target-vessel restenosis and a low rate of repeat revascularization. The pattern of restenosis was focal in almost half of the cases, and, in most remaining cases, restenosis affected short segments of the vessel.
authors.affiliation: Department of Cardiology (Drs. Avanzas, de la Hera, Lee, Lozano, Morís, Rondan, and Suárez), Hospital Universitario Central de Asturias, Oviedo 33006, Spain. inigo.lozano@gmail.com
authors.forename: Iñigo
authors.initials: I
authors.lastname: Lozano
authors.forename: Carlos
authors.initials: C
authors.lastname: Cuellas
authors.forename: Pablo
authors.initials: P
authors.lastname: Avanzas
authors.forename: Armando Pérez
authors.initials: AP
authors.lastname: de Prado
authors.forename: Concepción
authors.initials: C
authors.lastname: Suárez
authors.forename: Juan
authors.initials: J
authors.lastname: Rondan
authors.forename: Daehyun
authors.initials: D
authors.lastname: Lee
authors.forename: Jesus M
authors.initials: JM
authors.lastname: de la Hera
authors.forename: Felipe
authors.initials: F
authors.lastname: Fernández
authors.forename: César
authors.initials: C
authors.lastname: Morís
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002858:Chromium Alloys; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D011474:Prosthesis Design; D013030:Spain; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002858:Chromium Alloys; D010975:Platelet Aggregation Inhibitors