Comparison of long versus short ("spot") drug-eluting stenting for long coronary stenoses

Katritsis, Demosthenes G; Korovesis, Socrates; Tzanalaridou, Efthalia; Giazitzoglou, Eleftherios; Voridis, Eutychios; Meier, Bernhard (2009). Comparison of long versus short ("spot") drug-eluting stenting for long coronary stenoses. American journal of cardiology, 104(6), pp. 786-90. New York, N.Y.: Elsevier 10.1016/j.amjcard.2009.04.056

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We compared spot drug-eluting stenting (DES) to full stent coverage for treatment of long coronary stenoses. Consecutive, consenting patients with a long (>20 mm) coronary lesion of nonuniform severity and indication for percutaneous coronary intervention were randomized to full stent coverage of the atherosclerotic lesion with multiple, overlapping stenting (full DES group, n = 90) or spot stenting of hemodynamically significant parts of the lesion only (defined as diameter stenosis >50%; spot DES group, n = 89). At 1-year follow-up, 14 patients with full DES (15.6%) and 5 patients (5.6%) with spot DES had a major adverse cardiac event (MACE; p = 0.031). At 3 years, MACEs occurred in 18 patients with full DES (20%) and 7 patients (7.8%) with spot DES (p = 0.019). Cox proportional hazard model showed that the risk for MACEs was almost 60% lower in patients with spot DES compared to those with full DES (hazard ratio 0.41, 95% confidence interval 0.17 to 0.98, p = 0.044). This association remained even after controlling for age, gender, lesion length, and type of stent used (hazard ratio 0.42, 95% confidence interval 0.17 to 1.00, p = 0.05). In conclusion, total lesion coverage with DES is not necessary in the presence of diffuse disease of nonuniform severity. Selective stenting of only the significantly stenosed parts of the lesion is an appropriate therapeutic alternative in this setting, offering a favorable clinical outcome.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Meier, Bernhard

ISSN:

0002-9149

ISBN:

19733712

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:09

Last Modified:

04 May 2014 23:22

Publisher DOI:

10.1016/j.amjcard.2009.04.056

PubMed ID:

19733712

Web of Science ID:

000269981300008

URI:

https://boris.unibe.ch/id/eprint/30256 (FactScience: 191606)

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