Publication:

Clinical and angiographic outcomes of very long drug eluting stents in patients with coronary artery disease undergoing percutaneous coronary intervention: a prospective observational study

Background To evaluate the procedural feasibility and clinical and angiographic outcomes of very long drug-eluting stents (DES) in patients with diffuse coronary artery disease undergoing percutaneous coronary intervention (PCI).

Methods This observational study included 111 consecutive adult patients with de novo long coronary lesions treated with DES ≥48 mm between March 2018 and September 2019 at the Department of Cardiology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow. Clinical outcomes at 1 and 6 months included major adverse cardiac events (MACE) such as myocardial infarction, angina and congestive heart failure. Angiographic outcomes at 6 months included in-stent restenosis, target lesion revascularization, target vessel revascularization and stent thrombosis.

Results No significant correlation was observed between clinico-angiographic outcomes and stent length, stent diameter, stent polymer, multi-vessel PCI or diabetic status (p>0.05). However, diabetic status significantly affected clinical outcomes at 6 months (p=0.020). The incidence of angina was significantly higher at 6 months compared with 1 month. Survival analysis at 1 and 6 months showed no significant difference in patient survival (p=0.778).

Conclusions Very long DES implantation for diffuse coronary lesions appears safe and effective, with low rates of adverse clinical and angiographic events. Stent length, diameter and polymer type did not significantly influence outcomes.