Randomized comparison of success and adverse event rates and cost effectiveness of one long versus two short stents for treatment of long coronary narrowings

Hoffmann, Rainer; Herrmann, G.; Silber, Sigmund; Braun, Peter; Werner, Gerald S.; Hennen, Benno; Rupprecht, Hans-J.ürgen; Dahl, Julian; Hanrath, Peter

doi:10.1016/s0002-9149(02)02514-6

Cited by 26 publications

(20 citation statements)

References 20 publications

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“…Of note, the authors did report that the use of one long, solitary stent was associated with a reduction in catheterization time, dye volume usage, and duration of radiation exposure. Similar findings were reported in a prospective, randomized trial (10) with further mention that placement of one long stent for extensive lesions is also more cost effective. In a separate investigation from Spain (17), patients with a long coronary lesion (>20 mm) treated with a single long stent had no significant difference in 2-year outcomes compared to management with multiple stents (overlapping and non-overlapping).…”

Section: Discussionsupporting

confidence: 87%

Successful Treatment of Symptomatic Intracranial Carotid Artery Stenosis Using a 24-mm Long Bare Metal Coronary Stent

et al. 2017

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Background Intracranial arterial atherosclerosis represents a common cause of stroke. Despite aggressive and optimal medical management, many patients will unfortunately suffer additional cerebrovascular events. The role of endovascular intervention for intracranial atherosclerotic disease continues to be uncertain, particularly in regard to extensive, symptomatic stenosis. Case Description We present a case of a 42-year-old male with a complex medical history who presented with recurrent ischemic stroke in the ipsilateral hemisphere despite optimal medical management. Given the length of stenosis and the luminal size of the intracranial cavernous and petrous segments of the ICA, we utilized a bare metal coronary stent (4.0 mm × 24 mm). This represents one of the longest stents deployed for intracranial disease reported in the literature. Conclusion This case illustrates that a long coronary stent might be successfully utilized to manage extensive intracranial lesions. We also review the efficacy of using one very long stent versus multiple overlapping stents, with reference to the coronary angiography literature.

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Section: Discussionsupporting

confidence: 87%

Successful Treatment of Symptomatic Intracranial Carotid Artery Stenosis Using a 24-mm Long Bare Metal Coronary Stent

et al. 2017

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“…In-stent binary restenosis was reduced in the TAXUS group to 9.1% from 32.9% in the control patients (Pϭ0.0001; relative reduction, 72%). Published trials assessing the angiographic response to bare-metal stents implanted in long lesions predict a binary restenosis rate of 39% to 45%, 11,12 comparable with bare-metal stents used in the control limb of the other published drug-eluting stent trials of simple lesions, for example, 36.7% in the RAVEL trial, 5 35.4% in the SIRIUS trial, 6 and 42.3% in the E-SIRIUS trial. 7 Despite the already favorable angiographic result with the control (Express 2 ) stent, there was an additional 53% reduction in TVR (the primary end point of the study) from 19.4% to 9.1% in the TAXUS group compared with control (Pϭ0.0027).…”

Section: Discussionmentioning

confidence: 90%

Clinical Efficacy of Polymer-Based Paclitaxel-Eluting Stents in the Treatment of Complex, Long Coronary Artery Lesions From a Multicenter, Randomized Trial

et al. 2005

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on behalf of the TAXUS VI InvestigatorsBackground-Intracoronary polymer-based stent delivery of paclitaxel has been shown to be effective in reducing restenosis in simple coronary lesions, but the evidence base for contemporary use in longer, more complex coronary stenoses is lacking. Methods and Results-TAXUS VI is a prospective, multicenter, double-blind, randomized trial assessing clinical and angiographic outcomes of the TAXUS Moderate Release paclitaxel-eluting stent in the treatment of long, complex coronary artery lesions. Four hundred forty-eight patients at 44 sites were randomized (1:1) between a drug-eluting TAXUS Express 2 and an uncoated Express 2 control stent. Per protocol, the 9-month follow-up included an angiographic reevaluation in all patients. The primary end point was the rate of target-vessel revascularization 9 months after the study procedure; secondary end points included the rate of target-lesion revascularization and binary restenosis at follow-up. Mean lesion length in the study was 20.6 mm, with a mean stent-covered length of 33.4 mm. Of all lesions, 55.6% were classified as complex lesions (type C of the AHA/ACC classification). At 9 months, target-vessel revascularization was 9.1% in the TAXUS group and 19.4% in the control group (Pϭ0.0027; relative reduction, 53%). Target-lesion revascularization was reduced from 18.9% to 6.8%, respectively (Pϭ0.0001). The incidence of major adverse cardiac events was similar in the 2 groups, 16.4% and 22.5% in TAXUS and control, respectively (Pϭ0.12), including comparable rates for acute myocardial infarction. Binary restenosis in the stented area was reduced from 32.9% in the control group to 9.1% in the TAXUS patients (PϽ0.0001). Conclusions-The

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“…Recently, technological innovation allowed dedicated longer stents to be manufactured to avoid the limitations of multiple stents deployment. Advantages associated with the use of one very‐long stent compared with a multiple stents strategy include the reduction of procedure duration, contrast volume, radiation exposure both for the patient and the operator and cost of the procedure .…”

Section: Discussionmentioning

confidence: 99%

One‐year follow‐up of patients treated with new‐generation polymer‐based 38 mm everolimus‐eluting stent: The P38 study

Sgueglia

Belloni²,

Summaria³

et al. 2014

Cathet Cardio Intervent

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Randomized comparison of success and adverse event rates and cost effectiveness of one long versus two short stents for treatment of long coronary narrowings

Cited by 26 publications

References 20 publications

Successful Treatment of Symptomatic Intracranial Carotid Artery Stenosis Using a 24-mm Long Bare Metal Coronary Stent

Successful Treatment of Symptomatic Intracranial Carotid Artery Stenosis Using a 24-mm Long Bare Metal Coronary Stent

Clinical Efficacy of Polymer-Based Paclitaxel-Eluting Stents in the Treatment of Complex, Long Coronary Artery Lesions From a Multicenter, Randomized Trial

One‐year follow‐up of patients treated with new‐generation polymer‐based 38 mm everolimus‐eluting stent: The P38 study

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