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Early and long-term results of stenting of diffuse coronary artery disease
G Di Sciascio1, G Patti, G Nasso
1Department of Cardiovascular Sciences, Campus BioMedico University, Rome, Italy. g.disciascio@unicampus.it
Insights
Stenting diffuse coronary artery disease (CAD) in selected patients yields favorable outcomes. This study shows high rates of clinical success and freedom from major adverse events, supporting stent implantation for diffuse CAD.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Diffuse coronary artery disease (CAD) presents challenges for interventional procedures.
- Outcomes of stenting in diffuse CAD require further characterization.
Purpose of the Study:
- To evaluate the acute and long-term results of stent implantation in patients with diffuse coronary artery disease (CAD).
Main Methods:
- Stent implantation was performed in 100 consecutive patients with diffuse CAD.
- Diffuse CAD was defined by specific criteria including stenosis length and number.
- Follow-up included clinical assessment and angiographic evaluation.
Main Results:
- Angiographic and clinical success rates were 100% in the acute phase.
- No deaths or emergency coronary artery bypass surgery occurred during the acute phase.
- At a mean follow-up of 18 months, 77% remained asymptomatic, with 89% maintaining clinical improvement and 95% alive and free from bypass surgery.
Conclusions:
- Selected patients with diffuse coronary artery disease (CAD) can achieve satisfactory acute and long-term results with stent implantation.
- Stent implantation is a viable option for managing diffuse CAD, offering good clinical outcomes.
Abstract:
Diffuse coronary artery disease (CAD) is considered unfavorable for interventional procedures; however, the results of stenting of diffuse CAD have not been completely characterized. We performed stenting in 100 consecutive patients with diffuse CAD, defined as significant stenosis >20 mm (n = 59 patients), multiple significant stenoses in the same artery (n = 23 patients), or significant narrowing involving the whole length of the coronary artery (n = 18 patients). Angiographic success was achieved in 103 arteries (100%) and clinical success was obtained in all 100 patients. There were no deaths; no patient had stent closure, acute myocardial infarction, or required emergency coronary artery bypass surgery. All 100 patients had >6 months follow-up (mean 18 +/- 7 months, range 7 to 31); 77 (77%) remained asymptomatic, and 5 (5%) had acute myocardial infarction, of whom 2 died (2%). In-stent restenosis was observed in 12 patients (12%) and repeat angioplasty was performed in 10. Including those patients who underwent repeat angioplasty, 89 (89%) maintained clinical improvement and 95 (95%) were alive and free of bypass surgery during follow-up. Life-table analysis showed 86% freedom from death, myocardial infarction, and target lesion revascularization at 28 months. Thus, selected patients with diffuse CAD may be treated with satisfactory acute and long-term results by stent implantation.