Review: The outcomes of different vessel diameter in patients receiving coronary artery stenting.
Compared to bare metal stent (BMS) implantation, drug-eluting stents (DES) is significantly better in attenuating intimal hyperplasia and reducing the rate of revascularization. However, the requirement of prolonged dual antiplatelet therapy (DAPT) and the economic cost have been the major disadvantages of DES. Studies have shown that the use of DES in small vessels decrease revascularization rate, but the results in large vessels vary. Previous studies have shown that the extent of late loss is unrelated to vessel diameter, and that late loss is easily accommodated in large vessels, thus resulting in decreased clinical benefit of DES in this setting. No definite cut-off point value of the vessel size has yet been demonstrated. Series studies aimed at evaluating the clinical outcomes of DES versus BMS in large vessels, but their results have been controversial. In this review, we evaluate the latest studies on clinical outcomes for different vessel sizes and clinical conditions. Nonetheless, further large clinical trials are warranted to address the clinical results of newer stents in different size vessels, especially in large vessels.
Department of Cardiology, Chang Gung Memorial Hospital, Taipei, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Ming-Lung
ML
Tsai
Department of Cardiology, Chang Gung Memorial Hospital, Taipei, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Chun-Chi
CC
Chen
Department of Cardiology, Chang Gung Memorial Hospital, Taipei, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Dong-Yi
DY
Chen
Department of Cardiology, Chang Gung Memorial Hospital, Taipei, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Chia-Hung
CH
Yang
Department of Cardiology, Chang Gung Memorial Hospital, Taipei, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Ming-Jer
MJ
Hsieh
Department of Cardiology, Chang Gung Memorial Hospital, Taipei, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Cheng-Hung
CH
Lee
Department of Cardiology, Chang Gung Memorial Hospital, Taipei, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Chao-Yung
CY
Wang
Department of Cardiology, Chang Gung Memorial Hospital, Taipei, and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Shang-Hung
SH
Chang
Department of Cardiology, Chang Gung Memorial Hospital, Taipei, and College of Medicine, Chang Gung University, Taoyuan, Taiwan. Electronic address: hsiehic@ms28.hinet.net.
I-Chang
IC
Hsieh
D002986:Clinical Trials as Topic / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000639:trends*; D006801:Humans; D008670:Metals; D011474:Prosthesis Design / Q000639:trends*; D015607:Stents; D016896:Treatment Outcome
D008670:Metals
Bare metal stent; Coronary Artery Disease; Drug eluting stent; Stent