Long (> or = 25 mm) stents for long coronary artery lesions. A safe conduct or a bridge too far for the interventional cardiologist?

摘要

OBJECTIVE: Increased restenosis rates have been reported after stenting long lesions with multiple standard length stents. Long slotted tube stents have become available for the treatment of long lesions or dissections.To compare clinical outcome after the use of long Multi-Link stents in long coronary lesions versus standard length Multi-Link stents in Benestent type lesions. METHODS AND RESULTS: We evaluated clinical outcome (six months) of 147 consecutive patients in whom one or more > or = 25 mm long Multi-Link stents were successfully deployed.The results were compared with the West-2 registry in which a 15 mm Multi-Link stent was used. The patients with long stents had more complex lesions and unstable symptoms. Target lesion revascularization after six months follow-up was comparable with that observed after implantation of a standard length stent (6.9% vs. 6.1%, p = 0.81). Overall cardiac event-free survival was similar for both groups (89.7% vs. 91.5%, p = 0.73). CONCLUSIONS: Patients treated with one or more long (> or = 25 mm) Multi-Link stents have a similar event-free survival and an equivalent target lesion repeat revascularization risk after six months than patients treated with a standard length stent.