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Updated: May 5, 2026
Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model
Published on: September 14, 2009
Long-term clinical and angiographic follow-up after coronary stent placement in native coronary arteries
Takeshi Kimura1, Kenichi Abe, Satoshi Shizuta
1Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Insights
Coronary stenting remains safe and effective long-term (7-11 years). While clinical outcomes stabilize, late renarrowing of the artery lumen beyond 4 years is common, necessitating continued monitoring.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Device Technology
Background:
- Coronary stents improve cardiac event rates for 3-5 years.
- Long-term clinical and angiographic outcomes of coronary stenting require further clarification.
Purpose of the Study:
- To evaluate the long-term (7-11 years) clinical and angiographic outcomes of coronary stenting in native coronary arteries.
Main Methods:
- Analysis of clinical and angiographic follow-up data from 405 patients with successful coronary stenting.
- Assessment of primary or secondary stabilization (freedom from death, CABG, TL-PCI) within 14 months post-procedure.
- Quantitative angiographic analysis of luminal diameter changes over time in a subset of patients.
Main Results:
- 92% of patients achieved stabilization within 14 months; only 1.7% required more than two target lesion-percutaneous coronary interventions (TL-PCI).
- Freedom from TL-PCI plateaued between 80.7% and 84.9% from 1 to 8 years post-procedure.
- Angiographic analysis revealed early restenosis, intermediate-term regression, and significant late renarrowing beyond 4 years, with minimal luminal diameter decreasing significantly after 4 years.
Conclusions:
- Coronary stenting demonstrates sustained clinical efficacy and safety up to 7-11 years.
- Late luminal renarrowing beyond 4 years is a notable finding, indicating the need for extended patient follow-up.
- The study highlights the dynamic nature of stented arteries long-term, despite initial clinical stability.
Background:
Although coronary stents have been proved effective in reducing clinical cardiac events for up to 3 to 5 years, longer term clinical and angiographic outcomes have not yet been fully clarified.
Methods And Results:
To evaluate longer term (7 to 11 years) outcome, clinical and angiographic follow-up information was analyzed in 405 patients with successful stenting in native coronary arteries. Primary or secondary stabilization, which was defined as freedom from death, coronary artery bypass grafting, and target lesion-percutaneous coronary intervention (TL-PCI) during the 14 months after the initial procedure or after the last TL-PCI, was achieved in 373 patients (92%) overall. Only 7 patients (1.7%) underwent TL-PCI more than twice. After the initial 14-month period, freedom from TL-PCI reached a plateau at 84.9% to 80.7% over 1 to 8 years. However, quantitative angiographic analysis in 179 lesions revealed a triphasic luminal response characterized by an early restenosis phase until 6 months, an intermediate-term regression phase from 6 months to 3 years, and a late renarrowing phase beyond 4 years. Minimal luminal diameter in 131 patients with complete serial data were 2.62+/-0.4 mm immediately after stenting, 2.0+/-0.49 mm at 6 months, 2.19+/-0.49 mm at 3 years, and 1.85+/-0.56 mm beyond 4 years (P<0.0001).
Conclusions:
The efficacy and safety of coronary stenting seemed to be clinically sustained at 7 to 11 years of follow-up. However, late luminal renarrowing beyond 4 years was common, which demonstrates the need for further follow-up.
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