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Published on: May 14, 2013
Multi-vessel coronary stenting--procedural results and late clinical outcomes: a comparison with single-vessel
1Interventional Cardiology, Batra Hospital and Medical Research Centre, New Delhi, India.
Insights
Multi-vessel coronary artery stenting in selected patients shows high success and low complications. One-year outcomes are comparable to single-vessel stenting, demonstrating similar safety and efficacy for both procedures.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Coronary artery disease (CAD) management often involves percutaneous coronary intervention (PCI) with stenting.
- The clinical outcomes of multi-vessel versus single-vessel stenting require ongoing evaluation.
Purpose of the Study:
- To assess the 1-year clinical outcomes of multi-vessel coronary stenting.
- To compare these outcomes with single-vessel coronary stenting performed during the same period.
Main Methods:
- Retrospective analysis of 384 patients undergoing multi-vessel (2- or 3-vessel) stenting and 624 patients undergoing single-vessel stenting.
- Evaluation of in-hospital and 12-month clinical outcomes, including death, Q-wave myocardial infarction (MI), and repeat revascularization.
- Data collected between January 1, 1997, and January 31, 1999.
Main Results:
- High procedural success rates for both multi-vessel (99%) and single-vessel (98%) stenting.
- Similar procedural complication rates (2.9% vs. 2.6%).
- Comparable 1-year outcomes: target lesion revascularization (16% vs. 14%), repeat revascularization (19% vs. 20%), death (0.8% vs. 1.3%), and Q-wave MI (0.7% vs. 1.4%).
- Similar overall cardiac event-free survival (76% vs. 78%).
Conclusions:
- Multi-vessel coronary stenting in carefully selected patients achieves high procedural success with low complication rates.
- The 1-year clinical outcomes for multi-vessel stenting are acceptable and comparable to those of single-vessel stenting.
- These findings support the safety and efficacy of multi-vessel stenting in appropriate patient populations.
Abstract:
The purpose of this study was to assess the 1-year clinical outcome of patients with multi-vessel coronary artery disease (CAD) who underwent coronary stenting, and to compare the results with single-vessel coronary stenting carried out during the same period. We evaluated the in-hospital and 12-month clinical outcomes [death, Q-wave myocardial infarction (MI) and repeat revascularization rates at one year] in 384 consecutive patients treated with coronary stents in 2 (92% of patients) or 3 of the native coronary arteries and compared the outcome to 624 consecutive patients undergoing stenting in a single coronary artery between January 1, 1997 and January 31, 1999. The overall procedural success was obtained in 99% of patients with 2- or 3-vessel stenting and 98% of patients with single-vessel stenting. Procedural complications were similar (2.9% vs 2.6%; p = 0.12). During follow-up, target lesion revascularization was 16% in multi-vessel and 14% in single-vessel stenting (p = 0.38) and repeat revascularization was also similar for both groups (19% vs. 20%; p = 0.73). There was no difference in death (0.8% vs. 1.3%; p = 0.31) and Q-wave MI (0.7% vs. 1.4%; p = 0. 16) in the 2 groups. Overall cardiac event-free survival was similar for both groups (76% vs. 78%; p = 0.54). Multi-vessel stenting in carefully selected patients in our experience had a high procedural success with very low complication rates. The one-year clinical outcomes were acceptable and were similar to the results of single-vessel stenting.
