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Overlapping vs. one long stenting in long coronary lesions
Sang Hak Lee1, Yangsoo Jang, Sung Jin Oh
1Cardiology Division, Yonsei Cardiovascular Center, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
Summary
For long coronary lesions, overlapping stents offer similar outcomes to single long stents. Patient age and distal vessel diameter are key predictors of in-stent restenosis (ISR).
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Technology
Background:
- Treating long coronary artery lesions remains a clinical challenge.
- Optimal stent strategies for these lesions are not well-defined.
- Limited data exist on overlapping stents versus single long stents for long lesions.
Purpose of the Study:
- To compare the efficacy of overlapping stents versus a single long stent for long coronary lesions.
- To identify predictors of in-stent restenosis (ISR) in patients treated for long coronary lesions.
Main Methods:
- A prospective study involving 64 patients with long coronary lesions (> 20 mm).
- Patients were randomized to receive either one long stent (n=32) or two overlapping stents (n=32).
- Clinical and angiographic outcomes, including ISR rates, were assessed at follow-up.
Main Results:
- Both strategies demonstrated similar procedural success rates.
- Major adverse cardiac events occurred in 36% (single stent) and 29% (overlapping stents) (P=0.56).
- Six-month in-stent restenosis rates were comparable: 39% (single stent) and 41% (overlapping stents) (P=0.91).
Conclusions:
- Stent overlapping is a viable strategy for long coronary lesions, yielding outcomes comparable to single long stents.
- Patient age (≥ 65 years) was an independent predictor of ISR.
- Distal reference diameter < 2.5 mm showed a trend towards predicting ISR.