Boulmier Dominique, Bedossa Marc, Commeau Philippe, Huret Bruno, Gilard Martine, Boschat Jacques, Brunel Philippe, Leurent Bernard, Le Breton Hervé
Department of Cardiology, University Hospital of Rennes, Rennes, France.
Catheter Cardiovasc Interv. 2003 Jan;58(1):51-8. doi: 10.1002/ccd.10376.
To assess the outcomes of direct coronary stenting (DS) using long stents and examine predictive factors of DS failure, this prospective multicenter registry included 128 consecutive patients who underwent the implantation of stents >or= 18 mm in length without balloon predilation for de novo coronary artery stenoses. Mean lesion and stent lengths were 20.7 +/- 5.4 and 21.4 +/- 3.8 mm, respectively. Rates of DS success, lesion success, and primary success were 82%, 99%, and 97.7%, respectively. At 6 months, rates of MACE and TVR were 12.5% and 6.3%, respectively. In multivariate analysis, factors predictive of DS failure vs. DS success were presence of calcifications (78% vs. 45%; P = 0.004) and reference vessel diameter (2.77 +/- 0.4 vs. 3.13 +/- 0.42 mm; P = 0.0002). DS of complex lesions with stents >or= 18 mm in length was performed safely and with a high success rate. This strategy was less successful in the treatment of small vessels and in presence of calcifications.
为评估使用长支架进行直接冠状动脉支架置入术（DS）的结果并研究DS失败的预测因素，这项前瞻性多中心注册研究纳入了128例连续的患者，这些患者因初发冠状动脉狭窄接受了长度≥18 mm的支架植入且未进行球囊预扩张。平均病变长度和支架长度分别为20.7±5.4和21.4±3.8 mm。DS成功率、病变成功率和主要成功率分别为82%、99%和97.7%。在6个月时，主要不良心血管事件（MACE）和靶血管血运重建（TVR）发生率分别为12.5%和6.3%。多变量分析显示，DS失败与DS成功相比，预测因素为钙化的存在（78%对45%；P = 0.004）和参考血管直径（2.77±0.4对3.13±0.42 mm；P = 0.0002）。使用长度≥18 mm的支架对复杂病变进行DS操作安全且成功率高。该策略在小血管治疗和存在钙化的情况下成功率较低。
