title: Extended follow-up following "full-metal jacket" percutaneous coronary interventions with drug-eluting stents.
abstract: OBJECTIVE
  To report very long-term follow-up of "Full-Metal Jacket" (FMJ) percutaneous coronary interventions (PCI) in long-diffuse coronary lesions with drug-eluting stents (DES).
  
  
  BACKGROUND
  PCI for long-diffuse lesions may result in FMJ, which is not preferred by some operators due to long-term risk of restenosis and stent thrombosis. The data on long-term follow-up of patients with FMJ are limited and would be useful in understanding the safety and feasibility of such a strategy.
  
  
  METHODS
  Between April 2002 and March 2007, 274 patients (297 lesions in native coronary arteries) underwent PCI utilizing DES. FMJ was described as lesions requiring ≥ 60 mm of continuous stent. The measured endpoints were cardiac death, target-vessel myocardial infarction (MI), target lesion revascularization (TLR), target-vessel revascularization (TVR), and major adverse cardiac events (MACE) defined as composite of cardiac death, target-vessel MI, and TVR.
  
  
  RESULTS
  The mean age of patients was 62.1 ± 11 years. The mean length of total stents used was 75.1 ± 16.4 mm (60-150). During the median follow-up of 74.7 months (interquartile range: 58-96), the rates of cardiac death, MI, TLR, and TVR were: 5.8% (n = 16), 6.2% (n = 17), 27.3% (n = 81), and 30% (n = 89), respectively. The MACE rate was 34%. Definite and probable stent thrombosis occurred in 10 patients (3.6%).
  
  
  CONCLUSIONS
  The long-term follow-up of patients with FMJ is acceptable especially in regards to hard endpoints (death and MI) given the complexity of lesions treated. The high MACE rate was driven mainly by TVR. The availability of newer-generation DES and bioabsorbable scaffolds may improve these results. © 2014 Wiley Periodicals, Inc.
authors.affiliation: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Basavarajaiah
authors.forename: Toru
authors.initials: T
authors.lastname: Naganuma
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.forename: Tasuku
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Andrew
authors.initials: A
authors.lastname: Sharp
authors.forename: Ahmed
authors.initials: A
authors.lastname: Rezq
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sticchi
authors.forename: Filipo
authors.initials: F
authors.lastname: Figini
authors.forename: Antonio
authors.initials: A
authors.lastname: Amato
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011474:Prosthesis Design; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: drug-eluting stents; full-metal jacket; long-diffuse lesions