Korean Circ J.  2006 Jul;36(7):490-494. 10.4070/kcj.2006.36.7.490.

Clinical and Angiographic Outcome of Sirolimus-Eluting Stent for the Treatment of Very Long Lesions

• Park JS
• Kim YJ
• Shin DG
• Shim BS
• Hong GR
• Bae JH
• Nam CW
• Hur SH
• Han SW
• Kim KS
• Kim YN
• Kim KB
• Kim DI
• Kim DK
• Kim SM
• Yang TH
• Kim DS

• KMID: 2227096
• DOI: http://doi.org/10.4070/kcj.2006.36.7.490

Abstract

BACKGROUND AND OBJECTIVES: Compared to bare metal stent, drug-eluting stent has improved the clinical and angiographic outcomes for de novo, simple lesions. In real world clinical practice, we often encounter more complex, long lesions, which increase the rate of restenosis and cardiovascular events. The aim of this study was to evaluate the clinical and angiographic outcome of sirolimus-eluting stent (SES) for the treatment of very long lesions in real world clinical practice.
SUBJECTS AND METHODS
We implanted multiple SESs (>40 mm in total length) in 113 de novo lesions in 113 patients. The average length of the implanted stents was 58+/-14 mm (range: 41-112 mm) and a mean of 2.2 stents were implanted in each lesion and the average stent diameter was 3.0+/-0.3 mm.
RESULTS
Procedural and angiographic success were achieved in all the patients without death or coronary artery bypass surgery. Non-Q wave MI (CK-MB > or = 3 times the normal value) developed in 13 patients (11.5%). Two patients experienced late stent thrombosis after discharge (1.8%). The major adverse cardiac events (MACE)-free survival was 94% at 12 months. There were two sudden cardiac deaths. Six months follow up angiography was performed on 76 patients (67%) and angiographic binary restenosis developed in 7 patients (9.2%). All of them were the focal type in-stent restenosis and these were found to be located at the distal stents.
CONCLUSIONS
In conclusion, long lesion coverage with SESs is feasible with a favorable mid-term outcome in real world clinical practice.

Keyword

Percutaneous coronary angioplasty; Stents; Outcome

MeSH Terms

Angiography
Coronary Artery Bypass
Death, Sudden, Cardiac
Drug-Eluting Stents
Follow-Up Studies
Humans
Stents*
Thrombosis