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Korean Circ J. 2008 Feb;38(2):87-94. Korean. Original Article.
Lee SH , Chae JK , Lee KH , Lee SR , Rhee KS , Kim WH , Ko JK .
Division of Cardiology, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.

BACKGROUND AND OBJECTIVES: Drug-eluting stents (DES) are effective for the maintenance of patency in patients with various complex coronary artery diseases. We investigated the efficacy of full metal jackets (FMJs,> or =60 mm) using overlapping DES for very long coronary lesions. SUBJECTS AND METHODS: The medical records and angiographic data of ninety-nine patients, and 100 FMJs that were implanted at Chonbuk National University Hospital since March 2003, were analyzed. RESULTS: The mean age was 63+/-10 years and median follow-up period was 17.0 months. The mean lesion length was 57.7+/-10.8 mm, the mean number of implanted DES for FMJ was 2.2+/-0.5, and the mean length of the FMJ was 68.5+/-11.4 mm. Thirty percent of the lesions were the culprits of acute myocardial infarction and 22% were chronic total occlusive lesions. The procedural success rate was 98%. Triple antiplatelet agents were prescribed for 37.4% of the patients and the mean duration of clopidogrel use was 11.9+/-5.7 months. Overall major adverse cardiac events developed in 10% of patients. One patient died of probable stent thrombosis by the Academic Research Consortium definition. Follow-up coronary angiography was performed in 69% of cases. Binary restenosis was documented in 9 lesions (13.0%) and five FMJs (7.2%) were revascularized. Stent fractures were detected in four FMJs (5.8%). CONCLUSION: Although FMJs using DES may be regarded as a relatively safe and effective therapeutic approach for diffuse long coronary lesions, longer-term follow-up data with a larger population is needed to establish safety including special consideration for strategy of antiplatelet therapy.

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