title: Angiographic and clinical outcomes of everolimus-eluting stent in the treatment of extra long stenoses (AEETES).
abstract: OBJECTIVE
  The purpose of this study was to examine the angiographic and clinical results of stent full metal jacket in treating long lesions using everolimus-eluting stents (EES).
  
  
  BACKGROUND
  Data are lacking regarding the use of EES for this lesion subgroup.
  
  
  METHODS
  From 2007 to 2011, 77 symptomatic patients who had severe coronary stenoses necessitating implantation of stents with total length longer than 60 mm were treated with overlapping EES.
  
  
  RESULTS
  The mean age of patient was 61 ± 11 years with male predominance (66%). Diabetes mellitus was seen in 35 (45.5%) patients. Majority of patients had class III angina with normal heart function. On average, 3.1 stents were implanted per lesion; the mean stent size and length were 2.70 ± 0.28 mm and 82 ± 16 mm. Restudy angiography was performed on 71 patients (72 lesions) at 8.9 ± 2.5 months. Angiographic restenosis was seen in 9 (12.5%) lesions; the lesion length and late loss were 67 ± 15 mm and 0.4 ± 0.6 mm, respectively. The use of intravascular ultrasound has been found to be a predictor of less restenosis (P = 0.02; HR: 0.02; CI: 0.01-0.59). The in-hospital and 1 year major adverse cardiac event rates were 7.8% and 13%. The annual cardiac death rates were 2.6%, 3.4%, and 5.3% in the first 3 years.
  
  
  CONCLUSIONS
  The use of EES full metal jacket for long lesions is only associated with good short-term clinical and angiographic outcomes. Long-term follow-up has revealed a high cardiac death rate which may necessitate prolongation of dual antiplatelet therapy.
authors.affiliation: Cardiac Medical Unit, Grantham Hospital, Hong Kong. jimmanh2002@yahoo.com
authors.forename: Man-Hong
authors.initials: MH
authors.lastname: Jim
authors.forename: Kai-Hang
authors.initials: KH
authors.lastname: Yiu
authors.forename: Hee-Hwa
authors.initials: HH
authors.lastname: Ho
authors.forename: Wai-Ling
authors.initials: WL
authors.lastname: Chan
authors.forename: Andrew Kei-Yan
authors.initials: AK
authors.lastname: Ng
authors.forename: Chung-Wah
authors.initials: CW
authors.lastname: Siu
authors.forename: Wing-Hing
authors.initials: WH
authors.lastname: Chow
mesh_terms: D002316:Cardiotonic Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000453:epidemiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D002316:Cardiotonic Agents; D000068338:Everolimus; D020123:Sirolimus