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Treatment of long dissections by use of a single long or multiple short stents: clinical and angiographic follow-up.

Abstract：

BACKGROUND:Recently, long (> or =20 mm) coronary stents were introduced for clinical use. They are intended as an alternative to multiple conventional stents to treat extensive dissections or suboptimal results of long lesions after balloon angioplasty. METHODS:In a total of 113 such consecutive vessels in 107 patients, the flexible Freedom stent was implanted. In 60 of these vessels, because of anatomic constraints, multiple overlapping short (16 mm) stents were implanted. The other 53 vessels were treated with a single long (> or =20 mm) stent. RESULTS:In the single stent group there were four implantation failures (8%) successfully managed by crossover to multiple overlapping short stents. During early follow-up, in-stent thrombosis was not observed, but three patients with a single long stent and two patients with multiple overlapping stents suffered myocardial infarction as a result of long lasting myocardial ischemia during a difficult angioplasty procedure. At 6-month follow-up, > or =50% restenosis was measured in 29% and 35% of the patients with a single long stent and in those with multiple overlapping stents, respectively (not significant). CONCLUSIONS:Compared with the alternative treatment modality (i.e., implantation of multiple short stents), no difference between in-hospital and 6-month outcome was observed. However, implantation of a single long stent, when technically feasible, reduces catheterization time, dye volume for the patient, and radiation exposure for both patient and operator during these embarrassing angioplasty procedures.

journal_name

Am Heart J

journal_title

American heart journal

authors

De Scheerder IK,Wang K,Kostopoulos K,Dens J,Desmet W,Piessens JH

doi

10.1053/hj.1998.v136.89578

subject

Has Abstract

pub_date

1998-08-01 00:00:00

pages

345-51

issue

2

eissn

0002-8703

issn

1097-6744

pii

S0002-8703(98)00167-7

journal_volume

136

pub_type

杂志文章

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