Abstract
Drug-eluting stents (DES) are superior to bare metal stents in the prevention of restenosis and target lesion revascularization (TLR). This has led to a more aggressive use of DES in everyday interventional cardiology practice. Methods: All consecutive patients who underwent coronary artery stenting with greater than 34 mm of overlapping, sirolimus-eluting stent (SES) were reviewed from a prospectively created database. A prespecified group of patients with greater than 60 mm of SES was also followed. Results: 318 patients were followed up at a minimum of 6 months and a mean of 9 months. The mean target lesion stented length was over 55 mm. Use of IVUS was 19.8%. Forty patients (12.6%) suffered a peri-procedural CK-MB rise. The MACE rate at 9 months was 17% with 12.6% being periprocedural myocardial infarction (MI). Clinically driven TLR was 4.4% and cardiac death was 1.3%. There were 4 cases defined as late stent thrombosis. The independent predictors of periprocedural MI were the presence of a major side branch and longer target lesion stented length, with stable angina being a negative predictor. The independent predictors of in-stent restenosis were unstable angina and target lesion number per patient. There was a trend to increased MACE in the subgroup with longer than 60 mm of SES length. Conclusion: The use of multiple, overlapping SES is safe and effective with an acceptably low follow up MACE rate. A significant peri-procedural CK-MB rise appears to be a risk of long segment stenting. Whether this translates to long-term sequelae needs further investigation.
| Original language | English |
|---|---|
| Pages (from-to) | 231-237 |
| Number of pages | 7 |
| Journal | International Journal of Cardiology |
| Volume | 134 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - May 15 2009 |
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Keywords
- Coronary artery
- Drug eluting stents
- Overlapping
- Sirolimus
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Use of multiple overlapping sirolimus-eluting stents for treatment of long coronary artery lesions : Results from a single-center registry in 318 consecutive patients. / Ruchin, Peter E.; Trabattoni, Daniela; Fabbiocchi, Franco; Montorsi, Piero; Lualdi, Alessandro; Ravagnani, Paolo; Grancini, Luca; Galli, Stefano; Teruzzi, Giovanni; Calligaris, Giuseppe; De Martini, Stefano; Bartorelli, Antonio L.
In: International Journal of Cardiology, Vol. 134, No. 2, 15.05.2009, p. 231-237.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Use of multiple overlapping sirolimus-eluting stents for treatment of long coronary artery lesions
T2 - Results from a single-center registry in 318 consecutive patients
AU - Ruchin, Peter E.
AU - Trabattoni, Daniela
AU - Fabbiocchi, Franco
AU - Montorsi, Piero
AU - Lualdi, Alessandro
AU - Ravagnani, Paolo
AU - Grancini, Luca
AU - Galli, Stefano
AU - Teruzzi, Giovanni
AU - Calligaris, Giuseppe
AU - De Martini, Stefano
AU - Bartorelli, Antonio L.
PY - 2009/5/15
Y1 - 2009/5/15
N2 - Drug-eluting stents (DES) are superior to bare metal stents in the prevention of restenosis and target lesion revascularization (TLR). This has led to a more aggressive use of DES in everyday interventional cardiology practice. Methods: All consecutive patients who underwent coronary artery stenting with greater than 34 mm of overlapping, sirolimus-eluting stent (SES) were reviewed from a prospectively created database. A prespecified group of patients with greater than 60 mm of SES was also followed. Results: 318 patients were followed up at a minimum of 6 months and a mean of 9 months. The mean target lesion stented length was over 55 mm. Use of IVUS was 19.8%. Forty patients (12.6%) suffered a peri-procedural CK-MB rise. The MACE rate at 9 months was 17% with 12.6% being periprocedural myocardial infarction (MI). Clinically driven TLR was 4.4% and cardiac death was 1.3%. There were 4 cases defined as late stent thrombosis. The independent predictors of periprocedural MI were the presence of a major side branch and longer target lesion stented length, with stable angina being a negative predictor. The independent predictors of in-stent restenosis were unstable angina and target lesion number per patient. There was a trend to increased MACE in the subgroup with longer than 60 mm of SES length. Conclusion: The use of multiple, overlapping SES is safe and effective with an acceptably low follow up MACE rate. A significant peri-procedural CK-MB rise appears to be a risk of long segment stenting. Whether this translates to long-term sequelae needs further investigation.
AB - Drug-eluting stents (DES) are superior to bare metal stents in the prevention of restenosis and target lesion revascularization (TLR). This has led to a more aggressive use of DES in everyday interventional cardiology practice. Methods: All consecutive patients who underwent coronary artery stenting with greater than 34 mm of overlapping, sirolimus-eluting stent (SES) were reviewed from a prospectively created database. A prespecified group of patients with greater than 60 mm of SES was also followed. Results: 318 patients were followed up at a minimum of 6 months and a mean of 9 months. The mean target lesion stented length was over 55 mm. Use of IVUS was 19.8%. Forty patients (12.6%) suffered a peri-procedural CK-MB rise. The MACE rate at 9 months was 17% with 12.6% being periprocedural myocardial infarction (MI). Clinically driven TLR was 4.4% and cardiac death was 1.3%. There were 4 cases defined as late stent thrombosis. The independent predictors of periprocedural MI were the presence of a major side branch and longer target lesion stented length, with stable angina being a negative predictor. The independent predictors of in-stent restenosis were unstable angina and target lesion number per patient. There was a trend to increased MACE in the subgroup with longer than 60 mm of SES length. Conclusion: The use of multiple, overlapping SES is safe and effective with an acceptably low follow up MACE rate. A significant peri-procedural CK-MB rise appears to be a risk of long segment stenting. Whether this translates to long-term sequelae needs further investigation.
KW - Coronary artery
KW - Drug eluting stents
KW - Overlapping
KW - Sirolimus
UR - http://www.scopus.com/inward/record.url?scp=64849085105&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=64849085105&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2008.02.012
DO - 10.1016/j.ijcard.2008.02.012
M3 - Article
VL - 134
SP - 231
EP - 237
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 2
ER -