Cardiology Department, University General Hospital of Ciudad Real, Spain.
Interventional Cardiology Unit, Cardiology Department, University General Hospital of Ciudad Real, Spain.
Angiology. 2021 Nov;72(10):979-985. doi: 10.1177/00033197211014686. Epub 2021 May 10.
Both stent length and stent overlap are associated with worse outcomes in the percutaneous treatment of diffuse coronary artery disease (dCAD). However, evidence comparing these issues is scarce. We aimed to compare the results between the use of single very long stent (VLS) and ≥2 overlapping stents (OS) in the treatment of dCAD.
Seven hundred twenty-four consecutive lesions were included: 275 treated with a single VLS (≥40 mm) and 449 with ≥2 OS. Procedural characteristics were assessed, and survival analysis was performed to compare the incidence of major adverse cardiovascular events (MACE; composite of cardiovascular death, nonfatal myocardial infarction, target lesion revascularization [TLR], or stent thrombosis) during a median follow-up of 31 months.
Procedures with VLS required less contrast volume (268 ± 122 vs 302 ± 113 cm3; < .01), fluoroscopy time (16 ± 8 vs 21 ± 16 minutes; < .01), and procedure duration (37 ± 18 vs 47 ± 27 minutes; < .01) than the OS procedures. The VLS group showed lower incidence of MACE (4.4% vs 10.7%; < .01), driven mainly by lower TLR rate (1.1% vs 4.7%; < .01). The use of OS was an independent predictor of MACE.
In this study, the use of VLS for the treatment of dCAD was associated with better outcomes compared to OS.
支架长度和支架重叠与经皮弥漫性冠状动脉疾病（dCAD）的治疗效果较差相关。然而，比较这些问题的证据很少。我们旨在比较在治疗 dCAD 时使用单根超长支架（VLS）和≥2 个重叠支架（OS）的结果。
共纳入 724 例连续病变：275 例采用单根 VLS（≥40mm）治疗，449 例采用≥2 个 OS 治疗。评估了手术特点，并进行生存分析以比较中位随访 31 个月期间主要不良心血管事件（MACE；心血管死亡、非致死性心肌梗死、靶病变血运重建[TLR]或支架血栓形成的复合终点）的发生率。
VLS 组的手术需要的造影剂体积（268±122 比 302±113cm3；<0.01）、透视时间（16±8 比 21±16 分钟；<0.01）和手术时间（37±18 比 47±27 分钟；<0.01）均低于 OS 组。VLS 组的 MACE 发生率（4.4%比 10.7%；<0.01）较低，主要是由于 TLR 率较低（1.1%比 4.7%；<0.01）。OS 的使用是 MACE 的独立预测因素。
在这项研究中，与 OS 相比，VLS 治疗 dCAD 与更好的结果相关。
