Comparison of mid-term clinical outcomes between "complete full-metal jacket strategy" versus "incomplete full-metal jacket strategy" for diffuse right coronary artery stenosis with drug-eluting stents.
BACKGROUND
The optimal strategy for diffuse right coronary artery (RCA) stenosis remains unclear.


OBJECTIVE
The objective of this study was to compare the mid-term outcomes of "complete full-metal jacket (c-FMJ) stenting strategy" with "incomplete full-metal jacket (i-FMJ) stenting strategy" for the diffuse long RCA lesion using drug-eluting stents (DES).


METHODS
Between July 2007 and October 2015, 121 patients underwent percutaneous coronary intervention (PCI) for diffuse RCA lesions using DES. Fifty-three patients underwent c-FMJ PCI, whereas 68 patients underwent i-FMJ. Thirty patients received angiographical follow-up in the c-FMJ group, while 34 patients received angiographical follow-up in the i-FMJ group. The primary endpoint was major adverse cardiac events (MACE): cardiac death, stent thrombosis (ST), target lesion revascularization (TLR), and target vessel revascularization (TVR).


RESULTS
The incidence of MACE was significantly lower in the c-FMJ group (13.3%) as compared to the i-FMJ group (41.2%) (p=0.013). There was no cardiac death in either group. The incidence of ST was comparable between the i-FMJ group (2.9%) and c-FMJ group (3.3%) (p=1.00), while TLR was significantly less in the c-FMJ group (6.7%) compared to the i-FMJ group (32.4%) (p=0.011).


CONCLUSIONS
The mid-term MACE was significantly less in the c-FMJ group than in the i-FMJ group, indicating that c-FMJ stenting was a favorable strategy for the diffuse long RCA lesion.
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan. Electronic address: kei_the_chopper@hotmail.com.
Kei
K
Yamamoto
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Kenichi
K
Sakakura
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Yusuke
Y
Adachi
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Yousuke
Y
Taniguchi
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Hiroshi
H
Wada
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Shin-Ichi
SI
Momomura
Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Hideo
H
Fujita
D000368:Aged; D023921:Coronary Stenosis / Q000628:therapy*; D003643:Death; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D013927:Thrombosis / Q000209:etiology; D016896:Treatment Outcome
Drug-eluting stent; Full metal jacket; Percutaneous coronary intervention; Right coronary artery