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ȣ - 490074 228 |
Impact of Drug-eluting stents on the outcome of patients with diffuse long coronary lesion |
Department of Internal Medicine, College of Medicine, Pusan National University, Busan, Korea |
Hyeon Gook Lee, Kook Jin Chun, Jun Hyuk Oh, Dong Won Lee, Byung Jae Ahn, Seong Ho Kim, Joon Sang Lee, Moo Young Kim, Woo Hyung Bae, Woo Seog Ko, Joon Hoon Jeong, Jun Kim, June Hong Kim, Taek Jong Hong, Yung Woo Shin |
Backgroud: In the stent era, lesion length remains an important predictor for restenosis. Drug-eluting stents (DESs) have significantly reduced in-stent restenosis (ISR), but results in long lesions are still lacking. Therefore we investigated Impact of DES on the outcome of patients with diffuse long coronary lesion. Method: Between January 2004 to July 2005, 80 patients (94 lesions) with > 20-mm in lesion length who were treated with 1 or more DES and underwent follow-up coronary angiogram were selected for this study. The patients were divided into group 1 for those who had 21 to 35 mm in lesion length, group 2 with 36 to 50 mm in lesion length, and group 3 with > 51-mm in lesion length. Results: Mean follow-up duration was 9 months. At 6 months follow-up angiogram, 6.4% of lesions had binary ISR (5.0% group 1, 8.7% group 2 and 9.1% group 3). Clinical and angiographic data are in the below table. Lesion length was associated with increases in percent diameter stenosis and late lumen loss (per 15 mm of 6.9% and 0.21 mm). Conclusions: DESs implantation is considered safe and effective in the treatment of diffuse long lesion. However, lesion length was associated with increases in percent diameter stenosis and late lumen loss.
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(n=patient/lesion) |
Group 1 (52/60) |
Group 2 (19/23) |
Group 3 (9/11) |
P value |
Age(yrs) |
58±9 |
56±9 |
58±9 |
NS |
Men(%) |
73 |
61 |
73 |
NS |
Target artery(%) :
LM/ LAD/ LCX/ RCA |
0/50/23/27 |
0/61/35/4 |
0/55/0/45 |
NS |
SA/ UA/ AMI(%) |
46/27/27 |
48/18/34 |
36/26/36 |
NS |
Pre-PCI
RD(mm) |
3.13±0.29 |
3.04±0.23 |
3.02±0.26 |
NS |
Pre-PCI MLD(mm) |
0.65±0.20 |
0.66±0.21 |
0.56±0.33 |
NS |
Lesion length(mm) |
26.00±3.01 |
42.13±4.47 |
54.64±2.38 |
<0.05 |
Late lumen loss(mm) |
0.17±0.50 |
0.39±0.66 |
0.59±0.93 |
<0.05 |
% DS(mm) |
6.0±18.15 |
12.61±21.99 |
19.81±31.26 |
<0.05 |
ISR(%) |
5.00 |
8.70 |
9.10 |
NS |
MACE(%) |
6.67 |
8.70 |
9.09 |
NS |
Group
1 for those who had 21 to 35 mm in lesion length,
Group
2 for those who had 36 to 50 mm in lesion length, Group 3 for those who had >
51-mm in lesion length. SA/
UA/ AMI : stable angina/ unstable angina/ acute myocardial infarction, RD :
Reference diameter, MLD: Minimal lumen diameter, DS: diameter stenosis, ISR: In
stent restenosis, MACE: Major adverse cardiac
events
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