Stent length and outcomes after drug-eluting stent placement

Lee, Cheol Whan; Park, Seung‐Jung

doi:10.1097/mca.0000000000000493

Cited by 2 publications

(2 citation statements)

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“…Stenting long lesions located on the LAD appears to be a safe and effective approach at short-term follow-ups; nevertheless, open questions persist regarding the long-term outcomes, including the possibility of future treatment with LIMA implantation [ 6 ]. We cannot dismiss the risk of restenosis considering that the length of the stent implanted is directly related to the need for reintervention to treat intra-stent restenosis (ISR) [ 7 ]. In some instances, implanting a long stent may come as a solution for a complication requiring a rapid solution without sufficient commitment to optimization [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…We cannot dismiss the risk of restenosis considering that the length of the stent implanted is directly related to the need for reintervention to treat intra-stent restenosis (ISR) [ 7 ]. In some instances, implanting a long stent may come as a solution for a complication requiring a rapid solution without sufficient commitment to optimization [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Long Stent Implantation on the Left Anterior Descending Coronary Artery at a Follow-Up of More Than Five Years

Sticchi,

Tatali,

Ferraro

et al. 2023

JCM

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Background: Stent implantation represents the standard of care in coronary intervention. While a short stent implanted on a focal lesion located on the left anterior descending artery (LAD) seems a reasonable alternative to an internal mammary implant, the same for long stents is still debated. Methods: We reported the long-term data of 531 consecutive patients who underwent Percutaneous Coronary Intervention (PCI) with long stents in two highly specialized centres. The main inclusion criteria were the implantation of stents longer than 30 mm on the LAD and a minimum follow-up (FU) of five years. The primary endpoint was mortality, and the secondary endpoints were any myocardial infarction (MI), target vessel and lesion revascularization (TVR and TLR, respectively), and stent thrombosis (ST) observed as definite, probable, or possible. Results: In this selected population with characteristics of complex PCI (99.1%), the long-term follow-up (mean 92.18 ± 35.5 months) estimates of all-cause death, cardiovascular death, and any myocardial infarction were 18.3%, 10.5%, and 9.3%, respectively. Both all-cause and cardiovascular deaths are significantly associated with three-vessel disease (HR 6.8; confidence of interval (CI) 95% 3.844–11.934; p < 0.001, and HR 4.7; CI 95% 2.265–9.835; p < 0.001, respectively). Target lesion (TLR) and target vessel revascularization (TVR) are associated with the presence of three-lesion disease on the LAD (HR 3.4; CI 95% 1.984–5.781; p < 0.001; HR 3.9 CI 95% 2.323–6.442; p < 0.001, respectively). Re-PCI for any cause occurred in 31.5% of patients and shows an increased risk for three-lesion stenting (HR 4.3; CI 95% 2.873–6.376; p < 0.001) and the treatment of bifurcation with two stents (HR 1.6; 95% CI 1.051–2.414; p = 0.028). Stent thrombosis rate at the 5-year FU was 4.4% (1.3% definite; 0.9% probable; 2.1% possible), including a 1.7% rate of very-late thrombosis. The stent length superior to 40 mm was not associated with poor outcomes (all-cause death p = 0.349; cardiovascular death p = 0.855; MI p = 0.691; re-PCI p = 0.234; TLR p = 0.805; TVR p = 0.087; ST p = 0.189). Conclusion: At an FU of longer than five years, patients treated with stents longer than 30 mm in their LAD showed acceptable procedural results but poor outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%