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Updated: Oct 2, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Clinical outcome of patients undergoing endoluminal coronary artery reconstruction with three or more stents
V Mathew1, D Hasdai, D R Holmes
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Insights
Multiple coronary artery stenting offers high initial success but carries a higher risk of early closure and 6-month adverse events compared to single stenting. It serves as a viable alternative to emergency bypass surgery, though repeat interventions may be needed.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
- Vascular Surgery
Background:
- The use of multiple stents in a single coronary artery is rising.
- Outcomes for patients receiving multiple stents are not well-documented.
Purpose of the Study:
- To assess the outcomes of patients who received three or more contiguous stents in one coronary artery.
Main Methods:
- Analyzed clinical and angiographic data of 45 patients without prior coronary artery bypass graft (CABG) surgery who underwent multiple, contiguous stent implantation.
- Compared outcomes to a matched series of patients who underwent emergent CABG after failed angioplasty.
Main Results:
- Achieved 97.8% angiographic and 91.1% procedural success.
- Early stent occlusion occurred in 8.9% of patients.
- At 6 months, 23.3% of survivors experienced adverse events (death, myocardial infarction, CABG, repeat intervention, or severe angina).
- Multiple stenting was a reasonable alternative to emergent CABG for threatened or abrupt closure, with similar rates of death and Q-wave MI.
- Repeat percutaneous intervention was more frequent in the multiple stent group at 1 year (25% vs. 0%, p=0.01).
Conclusions:
- Multiple contiguous stenting has a high initial success rate but a notable incidence of early stent closure.
- Adverse events at 6 months were more frequent than with single stenting, often associated with adverse angiographic features.
- Multiple stenting is a viable alternative to emergent CABG in specific scenarios, but increased need for repeat percutaneous intervention should be expected.
Objectives:
We sought to evaluate the outcome of patients undergoing multiple (three or more), contiguous stent implantation within a single native coronary artery.
Background:
The implantation of multiple stents within a single coronary artery is increasing in frequency, although the outcome of such patients is not well described.
Methods:
Forty-five patients without previous coronary artery bypass graft surgery (CABG) undergoing multiple, contiguous stent implantation in a single coronary artery were identified. Clinical and angiographic characteristics and outcomes were analyzed.
Results:
The angiographic success rate was 97.8%. The procedural success rate was 91.1%; stent occlusion during the initial hospital period occurred in four patients (8.9%). Death, myocardial infarction (MI), CABG, repeat target vessel intervention or severe angina occurred in 10 (23.3%) of 43 hospital survivors at 6-months follow-up. The indication for stent placement was threatened or abrupt closure in 30 patients (66.7%). Of the 25 patients with abrupt or threatened closure whose clinical and angiographic data would have indicated emergent CABG had stents not been available, the frequency of in-hospital death and Q wave MI was similar to that of a matched consecutive series of patients at our institution who underwent emergent CABG after failed angioplasty. At 1 year, the frequency of death, Q wave MI, CABG and severe angina at 1 year was similar in the two groups; the need for repeat percutaneous intervention was more common in the stent group (25% vs. 0%, p = 0.01).
Conclusions:
Implantation of multiple, contiguous intracoronary stents was associated with a high initial success rate, although the incidence of early stent closure was relatively high. Adverse events at 6 months of follow-up were more frequent than previously reported for elective single-stent implantation; however, adverse angiographic characteristics such as dissection and thrombus were frequent in this group. In addition, the strategy of multiple stent implantation in the setting of failed angioplasty is a reasonable alternative to emergent CABG, although the need for further percutaneous intervention must be anticipated.
