Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma Jonan-ku, Fukuoka 814-0180, Japan.
J Cardiol. 2011 Mar;57(2):187-93. doi: 10.1016/j.jjcc.2010.11.005. Epub 2010 Dec 21.
It has been reported that the overlap of sirolimus-eluting stents (SESs) is associated with greater in-stent late lumen loss and more angiographic restenosis. The purpose of this study was to evaluate whether the site of such overlap shows increased or decreased late lumen loss as assessed by quantitative coronary angiogram.
We compared 7-month angiographic late lumen loss at the site of overlap in patients with multiple overlapping stents (overlap SES group, n=48) to that in patients with single stents (single SES group, n=144). With regard to baseline angiographic characteristics and procedural results, there were significant differences between the overlap SES group and the single SES group in lesion complexity, lesion length and reference diameter, minimal lumen diameter, and mean stent length. In-stent late lumen loss at the 7-month follow-up did not differ significantly between the two groups (overlap SES 0.25 ± 0.61 mm vs. single SES 0.10 ± 0.55 mm, p=0.11). Furthermore, the site of overlap in the overlap SES group did not show greater late lumen loss compared to the stented area in the single SES group (0.17 ± 0.55 mm vs. 0.10 ± 0.55 mm, p=0.43). The overlap SES group tended to be associated with an increase in binary restenosis compared with the single SES group (22.8% vs. 12.8%, p=0.08), while this value was 4.2% at the site of overlap. There were no significant differences in death, myocardial infarction, target lesion revascularization, or stent thrombosis between the two groups. In addition, stent length was the most independent factor of late lumen loss in the overlap SES group by multivariate logistic analysis, whereas it was not an independent factor of late lumen loss of the SES overlap segment.
The site of overlap of overlapping SES dose not associate with greater late lumen loss or a higher in-stent binary restenosis rate compared to single SES implantation. The overlapping of SES by itself did not increase in-stent late lumen loss.
有报道称，西罗莫司洗脱支架（SES）的重叠与支架内晚期管腔丢失增加和更多的血管造影再狭窄有关。本研究的目的是评估定量冠状动脉造影术评估时，重叠部位的重叠是否会导致晚期管腔丢失增加或减少。
我们比较了 7 个月时多重重叠支架患者（重叠 SES 组，n=48）和单支架患者（单 SES 组，n=144）重叠部位的血管造影晚期管腔丢失。在基线血管造影特征和手术结果方面，病变复杂性、病变长度和参考直径、最小管腔直径和平均支架长度方面，重叠 SES 组与单 SES 组有显著差异。两组在 7 个月随访时支架内晚期管腔丢失无显著差异（重叠 SES 组 0.25±0.61mm 比单 SES 组 0.10±0.55mm，p=0.11）。此外，重叠 SES 组的重叠部位与单 SES 组的支架区域相比，晚期管腔丢失无明显增加（0.17±0.55mm 比 0.10±0.55mm，p=0.43）。与单 SES 组相比，重叠 SES 组的二元再狭窄发生率呈上升趋势（22.8%比 12.8%，p=0.08），而重叠部位为 4.2%。两组之间的死亡率、心肌梗死、靶病变血运重建或支架血栓形成无显著差异。此外，多元逻辑分析显示，在重叠 SES 组中，支架长度是晚期管腔丢失的最独立因素，而不是 SES 重叠节段晚期管腔丢失的独立因素。
与单 SES 植入相比，重叠 SES 的重叠部位与晚期管腔丢失增加或支架内二元再狭窄发生率增加无关。SES 的重叠本身并不会增加支架内晚期管腔丢失。
