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Clinical and angiographic follow-up after single long GFX coronary stent implantation
Y Nakagawa1, K Yufu, S Nakamori
1Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Insights
Long GFX stents show similar success and thrombosis rates to short stents, but higher restenosis rates. Smaller distal reference vessel diameter predicts restenosis in long lesions treated with single long stents.
Area of Science:
- Cardiovascular Interventions
- Medical Device Technology
- Clinical Cardiology
Background:
- Late restenosis is a concern after coronary stent implantation.
- Optimizing stent length selection is crucial for long lesions.
- GFX stent implantation outcomes require further investigation.
Purpose of the Study:
- To identify predictors of late restenosis after GFX stent implantation.
- To compare outcomes of long versus short GFX stents.
- To evaluate the efficacy of single long-stent implantation for long lesions.
Main Methods:
- Prospective data collection of 141 long (24/30 mm) and 66 short (12/18 mm) GFX stent implantations.
- Comparison of procedural success, thrombosis, and 6-month angiographic follow-up.
- Analysis of reference vessel diameters in relation to restenosis.
Main Results:
- Similar clinical success (97%) and thrombosis rates (1.4% vs 0%) between long and short stents.
- Overall binary restenosis rates were 34.7% for long and 23.3% for short stents (P=NS).
- Restenosis rates increased with stent length (10.0% for 12mm to 39.2% for 30mm).
- Significantly smaller distal reference diameters were observed in lesions with restenosis (2.15 vs 2.55 mm, P<0.0001).
Conclusions:
- Single long-stent implantation is feasible with high success and low complication rates.
- Distal reference vessel size is a critical factor predicting restenosis in long lesions treated with single long stents.
- Careful patient selection based on distal vessel size is recommended for optimal outcomes with long GFX stents.
Abstract:
In order to identify predictors of late restenosis after GFX stent implantation, procedural and 6-month clinical and angiographic follow-up data of prospectively entered 141 consecutive lesions treated with a single long (24 or 30 mm) GFX stent were compared to 66 consecutive lesions requiring a single short (12 or 18 mm) stent. The initial clinical success rate of 97% and thrombosis rate of 1.4% with long stents were similar to 97% and 0% with short stents (P = NS). Their respective binary restenosis rates were 34.7% and 23.3% for long and short stents as a whole (P = NS), but being 10.0% for 12 mm, 26.0% for 18 mm, 31.3% for 24 mm, and 39.2% for 30 mm. When proximal and distal reference diameters at baseline were compared between the lesions with and without restenosis, proximal reference diameters were not statistically different (3.02+/-0.42 mm vs. 3.18+/-0.62 mm) and the restenosis group had significantly smaller distal reference diameters (2.15+/-0.48 mm vs. 2.55+/-0.53 mm, P<0.0001). The treatment of long lesions with single long-stent implantation can be accomplished with high success and low complication rates. Single long-stent implantation may be effective, if the distal reference size of the long narrowing is big enough to accept the stent.