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ȣ - 480390 30 |
| Do we have to cover fully normal to normal reference vessel beyond lesion length? |
| Division of Cardiology, Internal Medicine, Dongsan Medical Center, Keimyung University |
| Yun-Kyeong Cho, Chang-Wook Nam, Seung-Ho Hur, Kwon-Bae Kim, Min-Jung Kim, Chang-Wook Park, Young-Soo Lee, Sang-Hoon Lee, Seong-Wook Han, Kee-Sik Kim, Yoon-Nyun Kim |
Background: Longer drug eluting stent (DES) in relation to lesion length results in more beneficial outcomes. Unfortunately, we frequently met unavailable situation of longer DES usage in daily practice.
Objectives: This study investigated the relation between the stent/length ratio (SLLR) of DES and clinical outcomes. Methods: From February 2003 to June 2004, 105 patients (108 lesions) who underwent DES implantation and performed follow-up coronary angiogram were enrolled. Patients were divided into two groups : one group is QCA-driven SLLR < 1.13 (20th percentile, n=108) , and the other is > 1.13. Follow-up angiographic restenosis (percent diameter stenosis > 50%) and cardiac events were evaluated. Results: See the below table. Conclusions: Although “the longer is the better” principle has been used in the era of DES, the lesion length matching stent implantation also showed a lower angiographic restenosis rate and favorable clinical outcomes.
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|
Group
(n=patients /
lesions) |
SLLR
< 1.13
(n =
22 / 23) |
SLLR
³ 1.13
(n =
83 / 85) |
P
value |
|
Age (yrs)
Male (%)
Diabetes (%)
1/2/3 vessel disease (%)
Lesion length (mm)
Stent length
(mm)
Stent size
(mm)
Mean SLLR
TVR (%)
Nonfatal MI
(%)
Death (%)
Restenosis by QCA
(%) |
56.2
± 10.7
18
(81.8)
6
(27.3)
8/7/7 (36/32/32)
21.3
± 5.3
22.3
± 5.2
3.1
± 0.2
1.05
1
(4.5)
0
(0)
0
(0)
1
(4.3) |
57.8
± 11.3
62
(74.7)
14
(16.9)
42/30/11 (51/36/13)
14.8
± 4.3
22.3
± 5.2
3.1
± 0.3
1.57
3
(3.6)
0
(0)
0
(0)
4
(4.7) |
0.57
0.35
0.21
0.12
0.00
0.99
0.44
0.00
0.62
0.71 | TVR
: target vessel revascularization, MI : myocardial infarction, QCA :
quantitative coronary angiography
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