Korean Circ J.  2008 Nov;38(11):612-617. 10.4070/kcj.2008.38.11.612.

Impact of Drug-Eluting Stents on Clinical Outcomes in Patients With Diffuse Coronary Lesions

• Lee HG
• Chun KJ
• Cho KI
• Lee DW
• Oh JH
• Ahn BJ
• Kim SH
• Lee JS
• Kim MY
• Bae WH
• Ko WS
• Jeong JH
• Kim TI
• Lee HC
• Kim J
• Kim JH
• Hong TJ
• Shin YW

• KMID: 2225710
• DOI: http://doi.org/10.4070/kcj.2008.38.11.612

Abstract

BACKGROUND AND OBJECTIVES
In the era of stents, lesion length remains an important predictor of restenosis. Drug-eluting stents (DESs) have significantly reduced in-stent restenosis (ISR), but results in long lesions are still lacking. Therefore, we investigated the impact of DESs on clinical outcomes in patients with diffuse coronary lesions. SUBJECTS AND METHODS: Between January 2004 and January 2005, 80 patients (94 lesions) with lesions >20 mm in length were treated with one or more DESs and underwent follow-up coronary angiography. The patients were divided into three groups: Group 1 was composed of those with lesions 21 to 35 mm in length, Group 2 was composed of those with lesions 36 to 50 mm in length, and Group 3 was composed of those with lesions > or =51 mm in length. RESULTS: The mean clinical follow-up duration was 9 months. On the 6-month follow-up angiogram, 6.4% of the lesions had binary ISR (5.0% in group 1, 8.7% in group 2, and 9.1% in group 3). The percent diameter stenosis was 6.0+/-18.15% in Group 1, 12.61+/-21.99% in Group 2, and 19.81+/-31.26% in Group 3(p< 0.05). Late lumen loss was 0.17+/-0.50 mm in Group 1, 0.39+/-0.66 mm in Group 2, and 0.59+/-0.93 mm in Group 3 (p<0.05). Lesion length was associated with an increase in percent diameter stenosis and late lumen loss (of 6.9% and 0.21 mm per 15 mm). CONCLUSION: DES implantation is considered safe and effective in the treatment of diffuse lesions. However, lesion length may be associated with an increase in percent diameter stenosis and late lumen loss at 6-month follow-up.

Keyword

Coronary stenosis; Drug-eluting stents; Coronary restenosis

MeSH Terms

Constriction, Pathologic
Coronary Angiography
Coronary Restenosis
Coronary Stenosis
Drug-Eluting Stents
Follow-Up Studies
Humans
Stents

Figure

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  Fig. 1 Percent diameter stenosis among the 3 groups. Group 1 was composed of those patients who had lesions 21 to 35 mm in length, Group 2 was composed of those who had lesions 36 to 50 mm in length, and Group 3 was composed of those who had lesions ≥51 mm in length. *p<0.05. DS: diameter stenosis.

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  Fig. 2 Late lumen loss based on quantitative coronary angiography among the 3 groups. Group 1 was composed of those patients who had lesions 21 to 35 mm in length, Group 2 was composed of those who had lesions 36 to 50 mm in length, and Group 3 was composed of those who had lesions ≥51 mm in length. *p<0.05.

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