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Three-year follow-up after implantation of metallic coronary-artery stents
T Kimura1, H Yokoi, Y Nakagawa
1Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Insights
Coronary artery stenting offers sustained benefits, with a low revascularization rate for stented lesions up to three years. Late improvements in vessel diameter were observed post-stenting.
Area of Science:
- Interventional Cardiology
- Vascular Medicine
- Biomedical Engineering
Background:
- Coronary artery stents are used to prevent restenosis after angioplasty.
- The long-term efficacy of coronary artery stenting remains under investigation.
Purpose of the Study:
- To evaluate the long-term clinical and angiographic outcomes of Palmaz-Schatz metallic coronary artery stents.
- To assess the durability of stent benefits up to three years post-implantation.
Main Methods:
- Clinical and angiographic data were analyzed for 143 patients with 147 native coronary artery lesions treated with Palmaz-Schatz stents.
- Follow-up extended up to three years, including coronary angiography at six months, one year, and three years.
Main Results:
- Survival free from adverse events (myocardial infarction, bypass surgery, re-angioplasty) was 74.6% at three years.
- Minimal luminal diameter decreased initially but stabilized by one year, with significant late improvement observed by three years.
- Revascularization of stented lesions was infrequent (2.1% at 14 months), contrasting with new lesion interventions (7.7%).
Conclusions:
- Coronary artery stenting demonstrates favorable long-term clinical and angiographic results.
- A low rate of revascularization for stented lesions is observed up to three years.
- Late lumen diameter improvement occurs between six months and three years after stenting.
Background:
Coronary-artery stents are known to reduce rates of restenosis after coronary angioplasty, but it is uncertain how long this benefit is maintained.
Methods:
We evaluated clinical and angiographic follow-up information for up to three years after the implantation of Palmaz-Schatz metallic coronary-artery stents in 143 patients with 147 lesions of native coronary arteries.
Results:
The rate of survival free of myocardial infarction, bypass surgery, and repeated coronary angioplasty for stented lesions was 74.6 percent at three years. After 14 months, revascularization of the stented lesion was necessary in only three patients (2.1 percent). In contrast, coronary angioplasty for a new lesion was required in 11 patients (7.7 percent). Follow-up coronary angiography of 137 lesions at six months, 114 lesions at one year, and 72 lesions at three years revealed a decrease in minimal luminal diameter from 2.54 +/- 0.44 mm immediately after stent implantation to 1.87 +/- 0.56 mm at six months, but no further decrease in diameter at one year (in patients with paired angiograms, 1.95 +/- 0.49 mm at both six months and one year). Significant late improvement in luminal diameter was observed at three years (in patients with paired angiograms, 1.94 +/- 0.48 mm at six months and 2.09 +/- 0.48 mm at three years; P < 0.001).
Conclusions:
Clinical and angiographic outcomes up to three years after coronary-artery stenting were favorable, with a low rate of revascularization of the stented lesions. Late improvement in luminal diameter appears to occur between six months and three years.