Key result
A single long stent shows no difference in restenosis or MACE compared to overlapping stents.
Why the study?
Long diffuse CAD is increasingly prevalent, but clinical and angiographic differences between single long stents versus overlapping stents for very long coronary lesions in chronic coronary syndromes were unclear.
Does a single long drug-eluting stent improve clinical or angiographic outcomes compared to overlapping stents in patients with chronic coronary syndromes and very long coronary lesions?
Cohort (n=550)
Does a single long drug-eluting stent improve clinical or angiographic outcomes compared to overlapping stents in patients with chronic coronary syndromes and very long coronary lesions?
Single long stents and overlapping stents yield comparable clinical and angiographic outcomes in patients with chronic coronary syndromes and very long coronary lesions.
Single long stents may offer a viable alternative to overlapping in long lesions; leaves open need for randomized confirmation.
BACKGROUND: The prevalence of long diffuse coronary artery disease (CAD) is increasing nowadays due to increase prevalence of multiple risk factors and population ageing. We aimed in our study to show the differences clinically or angiographically (guided by IVUS) between the use of single long stent versus overlapping stents in very long coronary lesions (≥40 mm) in patients presented with chronic coronary syndromes. METHODS: 550 patients presenting with chronic coronary syndromes were included: 320 treated with a single long stent (≥40 mm) and 230 patients with two or more overlapping stents. Angiographic follow-up (guided by IVUS) 6 months after PCI was performed only in 50 patients. We assessed the procedural characteristics and the occurrence of major adverse cardiovascular events (MACE) after a median follow-up of 24 months. RESULTS: < 0.001). Regarding IVUS subgroup follow-up, there was no significant difference between both groups regarding in-stent restenosis and MACE. CONCLUSIONS: We can conclude that long or overlapping stents are both acceptable therapeutic choices for patients with long CAD. There was no difference between both strategies regarding angiographic follow-up guided by IVUS after 6 months.
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Naguib et al. (2023) conducted a cohort in Chronic coronary syndromes with very long coronary lesions (n=550). Single long stent (≥40 mm) vs. Two or more overlapping stents was evaluated on Major adverse cardiovascular events (MACE). A single long stent (≥40 mm) showed no significant difference compared to overlapping stents regarding in-stent restenosis and MACE over a median 24-month follow-up.
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