Single Long Stents versus Overlapping Multiple Stents in the Management of Very Long Coronary Lesions: Comparisons of Procedures and Clinical Outcomes

• DOI: 10.18502/jthc.v14i3.1427
• Publication Date: 2019-09-07T07:51:47Z
• Authors: Alireza Amirzadegan; Mahdi Hasanabadi; Seyedmohammad Saa...; Mohsen Afarideh; Negar Omidi; Hassan Aghajani; Mohammad Alidoosti; Hamidreza Pourhos...; Mojtaba Salarifar; Younes Nozari
• Keywords: Mace; Clinical endpoint

Background: Different percutaneous coronary intervention (PCI) strategies, including the use of single long stents (SLSs) and overlapping multiple (OMSs), have been introduced to treat very lesions (VLCLs). The aim this study was compare procedural long-term clinical outcomes between SLSs OMSs in patients with VLCLs.
 Methods: In historical cohort study, 1709 who underwent PCI new generation drug-eluting (length ≥38 mm) were stratified into SLS [PROMUS /Resolute/XIENCE (PRX), (=38 mm), n=1121 (65.59%) BioMime, (≥40 n=124 (7.26%)] OMS [(59.43±10.80 n=464 (27.2%)] groups followed up for 440.93±361.32 days. endpoints comprised immediate post-PCI outcomes, major adverse cardiovascular events (MACE), patient-oriented composite endpoint (POCE), device-oriented (DOCE) at follow-up. 
 Results: mean age 59.28±10.60 years, 69.6% them male. Flow grade 3 (P=0.296) residual stenosis (P=0.533) statistically similar all groups. A lower level troponin observed BioMime group [14.52 (IQR25%-75%:10.44–22.42) ng/L; P=0.031] than PRX [18.63 (IQR25%-75%:10.51–34.02) ng/L 18.96 (IQR25%-75%:11.17–35.34) respectively]. Similarly, received amounts contrast agent [206.29±49.15 mL 208.06±55.23 mL; respectively] did [265.50±74.69 P<0.001]. There no significant differences incidence MACE [81 (7.2%), 7 (5.6%), 28 (6.0%); P=0.603], POCE [141 (12.6%), 13 (10.5%), 54 (11.6%); P=0.731], DOCE [51 (4.5%), 4 (3.2%), 21 (4.5%); P=0.791] PRX, groups, respectively.
 Conclusion: treatment VLCLs, appear outcomes. ultra-long may comparable results stents.