Key result
Longer lesion length is linked to ~0.2 mm greater late lumen loss per 15 mm.
Cohort (n=80)
Yes
Effect estimate: 0.21 mm increase per 15 mm
Absolute Event Rate: 0.59% vs 0.17%
p-value: p=<0.05
Longer lesions predict higher late loss after DES; extends prior predictors but hypothesis-generating and should not yet change practice.
Background and Objectives: In the era of stents, lesion length remains an important predictor of restenosis.Drugeluting 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 ≥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±0.50mm in Group 1, 0.39±0.66mm in Group 2, and 0.59±0.93mm 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.(Korean Circ J 2008;38:612-617)
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Lee et al. (2008) conducted a cohort in Diffuse coronary lesions (n=80). Increasing coronary lesion length vs. Shorter diffuse coronary lesions (21-35 mm) was evaluated on Late lumen loss at 6-month follow-up (0.21 mm increase per 15 mm, p=<0.05). In patients with diffuse coronary lesions treated with drug-eluting stents, longer lesion length was associated with significant increases in late lumen loss (0.21 mm per 15 mm) and percent diameter stenosis at 6-month follow-up.
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