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Updated: Aug 16, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Improved long-term survival associated with stent deployment during percutaneous coronary interventions: results from
Joseph B Muhlestein1, Jeffrey L Anderson, ChangZong Cui
1Division of Cardiology, Department of Cardiovascular Medicine, LDS Hospital, Salt Lake City, Utah 84143, USA. ldbmuhle@ihc.com
Insights
Stenting during percutaneous coronary intervention (PCI) significantly reduces long-term mortality and major adverse cardiac events. This large study confirms that stent use improves procedural success and patient outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Percutaneous coronary intervention (PCI) commonly utilizes stents to enhance procedural success and minimize restenosis.
- However, limited large-scale, long-term data exist on the impact of stenting on patient mortality.
Purpose of the Study:
- To evaluate the long-term effects of stent use versus non-stented procedures on mortality and major adverse cardiac events in patients undergoing PCI.
- To determine if stent implantation is associated with improved long-term survival.
Main Methods:
- A prospective study of 3399 patients undergoing PCI between 1994 and 2001.
- Patients were divided into stented (n=2456) and non-stented (n=942) groups, with follow-up extending to 54 months.
- Clinical outcomes, including mortality and major adverse cardiac events, were meticulously tracked.
Main Results:
- Stenting demonstrated higher angiographic success rates and acute gain compared to non-stented procedures.
- Procedural complications, 6-month restenosis, and 8-year mortality were significantly lower in the stented group.
- Multivariable analysis confirmed stent use as an independent predictor of reduced long-term mortality (HR=0.76, P=0.04).
Conclusions:
- Stent implantation in PCI, particularly with dual antiplatelet therapy, significantly reduces long-term mortality.
- The findings support the routine consideration of stent use whenever feasible during PCI procedures.
- Stenting offers advantages beyond procedural success, including improved long-term survival and reduced adverse cardiac events.
Introduction:
The use of stents in percutaneous coronary intervention (PCI) improves procedural success and reduces restenosis. However, few studies have had a sufficient sample size or adequate follow-up to determine whether this advantage results in a positive effect on mortality.
Methods:
A total of 3399 patients undergoing PCI (stented [with dual antiplatelet therapy]: n = 2456, nonstented [balloon PCI or rotational atherectomy]: n = 942) at a single institution from 1994 to 2001 were followed up prospectively (43 +/- 22 and 54 +/- 25 months, respectively) for acute and long-term clinical outcomes.
Results:
Angiographic success (< 50% residual stenosis) (99.7% vs 97.7%, P < .001) and acute gain (3.02 +/- 0.55 vs 2.08 +/- 0.62 mm, P < .001) were both greater for stented lesions. Likewise, procedural complications of death (0.04% vs 0.4%, P = .02) and dissection (4.9% vs 8.0%, P = .001) were lower in the stent group, as were rates of 6-month clinical restenosis (10.3% vs 16.3%, P < .001). Eight-year mortality (12.0% vs 18.2%, hazard ratio = 0.78, P = .009) was lower among the stent group, as was long-term major adverse cardiac events (36.2% vs 50.6%, P < .001), but no difference in long-term myocardial infarction was found (6.5% vs 7.6%, P = .28). In multivariable Cox regression, stent use (hazard ratio = 0.76, 95% CI [0.58-0.99], P = .04) remained associated with significantly reduced mortality.
Conclusion:
This large prospective study demonstrates that, in addition to a general improvement in procedural success and a reduced need for repeat revascularization, the use of stents with dual antiplatelet therapy was associated with a significant reduction in long-term mortality. Consideration should be given for the use of stents whenever feasible during PCI.
