Long Stent Implantation in Long Coronary Lesions: Immediate and Follow-up Results

Background:The results of new devices for long coronary stenotic lesion is disappointing. We evaluate the feasibility and efficacy of single long coronary stenting for long coronary stenosis, we implanted two types of long stents, newly developed less shortening Wall stent and Gianturco-Roubin II stent. Methods:This study reports on the use of stents in 106 patients with 109 lesions with long lesion. Long coronary disease was defined as a lesion length longer than 20 mm. After the implantation of the stent, the stented coronary segment was dilated further with high pressure balloon inflation to achieve angiographic optimization. Results:The mean age was 59±9 years. Mean stent length was 35±11 mm. Vessel distribution was 2 (2%) left main, 66 (61%) LAD, 10 (9%) LCX and 31 (28%) RCA. Implanted stents were 57 (52%) Gianturco-Roubin II stents and 52 (48%) Wall stents. Procedural success was achieved in 109 (100%) lesions. The MLD at lesion site increased from 0.8±0.4 mm to 3.2±0.5 mm. Procedure associated complications included 4 non-Q myocardial infarction. Angiographic follow up at 6 months was performed on 78 (72%) eligible lesions. There was one myocardial infarction and no death during follow up period. Restenosis by 50% diameter stenosis criteria was present in 39 (50%) of lesions. The target lesion revascularization was performed in 21 (19%) lesions. Conclusions:Stent implantation for long coronary disease is associated with excellent procedural success rates and low complication rates in the majority of patients. However, the restenosis rate is high regardless of the stent used. Further study needs to be done to improve the long-term clinical outcome. (Korean Circulation J 1998;28(6):902-908)