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KMID : 0368120080380110612
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Korean Circulation Journal
2008 Volume.38 No. 11 p.612 ~ p.617
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Impact of Drug-Eluting Stents on Clinical Outcomes in Patients With Diffuse Coronary Lesions
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Lee Hyeon-Gook
Cho Kyoung-Im
Kim Tae-Ik
Kim Jun
Hong Taek-Jong
Kim June-Hong
Chun Kook-Jin
Lee Dong-Won
Oh Jun-Hyuk
Ahn Byung-Jae
Kim Seong-Ho
Lee Joon-Sang
Kim Moo-Young
Bae Woo-Hyung
Ko Woo-Seog
Jeong Joon-Hoon
Lee Han-Cheol
Shin Yung-Woo
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Abstract
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Background and Objectives: In the era of stents, lesion length remains an important predictor of restenosis. Drug-eluting stents (DESs) have significantly reduced in-stent restenosis (ISR), but results in long lesions are still lacking. Therefore, we investigated the impact of DESs on clinical outcomes in patients with diffuse coronary lesions.
Subjects and Methods: Between January 2004 and January 2005, 80 patients (94 lesions) with lesions >20 mm in length were treated with one or more DESs and underwent follow-up coronary angiography. The patients were divided into three groups: Group 1 was composed of those with lesions 21 to 35 mm in length, Group 2 was composed of those with lesions 36 to 50 mm in length, and Group 3 was composed of those with lesions ≥51 mm in length.
Results: The mean clinical follow-up duration was 9 months. On the 6-month follow-up angiogram, 6.4% of the lesions had binary ISR (5.0% in group 1, 8.7% in group 2, and 9.1% in group 3). The percent diameter stenosis was 6.0±18.15% in Group 1, 12.61±21.99% in Group 2, and 19.81±31.26% in Group 3 (p<0.05). Late lumen loss was 0.17±0.50 mm in Group 1, 0.39±0.66 mm in Group 2, and 0.59±0.93 mm in Group 3 (p<0.05). Lesion length was associated with an increase in percent diameter stenosis and late lumen loss (of 6.9% and 0.21 mm per 15 mm).
Conclusion: DES implantation is considered safe and effective in the treatment of diffuse lesions. However, lesion length may be associated with an increase in percent diameter stenosis and late lumen loss at 6-month follow-up.
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KEYWORD
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Coronary stenosis, Drug-eluting stents, Coronary restenosis
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