Related Experiment Video
Updated: Feb 27, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Full Metal Jacket With Drug-Eluting Stents for Coronary Chronic Total Occlusion
Pil Hyung Lee1, Seung-Whan Lee2, Sung-Cheol Yun2
1Department of Cardiology, Center for Medical Research and Information, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Insights
The "full metal jacket" (FMJ) stenting procedure for coronary chronic total occlusions (CTOs) shows acceptable long-term results. However, persistent narrowing after stenting increases the risk of adverse events.
Area of Science:
- Interventional Cardiology
- Cardiovascular Research
- Medical Device Technology
Background:
- The "full metal jacket" (FMJ) stenting technique is frequently employed for coronary chronic total occlusions (CTOs).
- The long-term clinical efficacy and safety of the FMJ procedure remain incompletely understood.
Purpose of the Study:
- To assess the long-term outcomes of successful "full metal jacket" (FMJ) procedures using drug-eluting stents in treating coronary chronic total occlusions (CTOs).
- To identify predictors of adverse events following FMJ stenting for CTOs.
Main Methods:
- A retrospective analysis of 1,126 successful CTO procedures (1,107 patients) between May 2003 and March 2015.
- The primary endpoint was target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction, or target lesion revascularization/reocclusion.
- Multivariate analysis was used to identify predictors of TLF.
Main Results:
- The FMJ procedure was performed in 406 patients (36.7%), with increasing frequency over time.
- The median follow-up was 5.1 years, with a TLF rate of 16.0%.
- Predictors of increased TLF risk included the number of implanted stents (HR 1.72) and persistent distal luminal narrowing (HR 2.73).
Conclusions:
- The FMJ procedure with drug-eluting stents for CTOs demonstrates acceptable long-term clinical outcomes.
- Persistent distal luminal narrowing post-stenting is a significant predictor of future adverse events, even after a technically successful procedure.
Objectives:
The aim of this study was to evaluate the long-term outcomes and predictors of adverse events following successful "full metal jacket" (FMJ) (stent length ≥60 mm without gap) procedures using drug-eluting stents to treat coronary chronic total occlusions (CTOs).
Background:
The FMJ stenting procedure is often required to treat CTOs, but its clinical efficacy and safety remain unknown.
Methods:
In total, 1,126 successful CTO procedures (1,107 consecutive patients) performed between May 2003 and March 2015 were studied. The primary endpoint was target lesion failure, a composite of cardiac death, target vessel-related myocardial infarction, or target lesion revascularization or reocclusion.
Results:
Overall, 406 patients (36.7%) underwent the FMJ procedure, increasing in frequency over time (28.5% from 2003 to 2006 and 41.7% after 2011). The mean stent length was 76.8 ± 14.6 mm (range 60 to 122 mm), and the average number of stent overlaps was 2.5 ± 0.6 (range 2 to 4). A total of 127 patients (31.3%) had persistent luminal narrowing at the distal reference segment after stenting. During the median follow-up period of 5.1 years, target lesion failure occurred in 16.0% of patients. There were 17 cases of total reocclusion and 5 cases of stent thrombosis. Multivariate analysis confirmed that the number of implanted stents (hazard ratio: 1.72; 95% confidence interval: 1.16 to 2.54; p = 0.006) and persistent distal luminal narrowing (hazard ratio: 2.73; 95% confidence interval: 1.66 to 4.47; p < 0.001) were predictors of increased risk for target lesion failure.
Conclusions:
The FMJ procedure using drug-eluting stents for CTOs provides acceptable long-term clinical results. Persistent distal luminal narrowing increases the future likelihood of adverse events despite procedural success.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:30Acute Coronary Syndrome I: Introduction
01:18Endocarditis III: Medical Management
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:27Peripheral Artery Disease III: Interprofessional Care