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KMID : 0368120080380020087
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Korean Circulation Journal
2008 Volume.38 No. 2 p.87 ~ p.94
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Full Metal Jackets (≥60 mm) of Drug-Eluting Stents: Short- and Long-term Clinical and Angiographic Outcomes
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Lee Sun-Hwa
Chae Jei-Keon
Lee Kang-Hyu
Lee Sang-Rok
Lee Kyoung-Suk
Kim Won-Ho
Ko Jae-Ki
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Abstract
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Background and Objectives: Drug-eluting stents (DES) are effective for the maintenance of patency in patients with various complex coronary artery diseases. We investigated the efficacy of full metal jackets (FMJs,≥60 mm) using overlapping DES for very long coronary lesions.
Subjects and Methods: The medical records and angiographic data of ninety-nine patients, and 100 FMJs that were implanted at Chonbuk National University Hospital since March 2003, were analyzed.
Results: The mean age was 63±10 years and median follow-up period was 17.0 months. The mean lesion length was 57.7±10.8 mm, the mean number of implanted DES for FMJ was 2.2±0.5, and the mean length of the FMJ was 68.5±11.4 mm. Thirty percent of the lesions were the culprits of acute myocardial infarction and 22% were chronic total occlusive lesions. The procedural success rate was 98%. Triple antiplatelet agents were prescribed for 37.4% of the patients and the mean duration of clopidogrel use was 11.9±5.7 months. Overall major adverse cardiac events developed in 10% of patients. One patient died of probable stent thrombosis by the Academic Research Consortium definition. Follow-up coronary angiography was performed in 69% of cases. Binary restenosis was documented in 9 lesions (13.0%) and five FMJs (7.2%) were revascularized. Stent fractures were detected in four FMJs (5.8%).
Conclusion: Although FMJs using DES may be regarded as a relatively safe and effective therapeutic approach for diffuse long coronary lesions, longer-term follow-up data with a larger population is needed to establish safety including special consideration for strategy of antiplatelet therapy
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KEYWORD
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Drug-Eluting stents, Percutaneous transluminal coronary angioplasty
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