From the Cardiac Catheterization Laboratory, Division of Cardiology,
Washington Hospital Center, Washington, DC.
Background—Previous reports have
suggested higher procedural and long-term complications among patients
treated with multiple stents for diffuse lesions and/or long
dissections.
Methods and Results—To evaluate procedural success, major
complications, and clinical outcomes (
Conclusions—Patients treated with multiple (
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Procedural Results and Late Clinical Outcomes After Placement of Three or More Stents in Single Coronary Lesions
1 year) in a consecutive series
of patients treated with multiple (3) contiguous stents in single
lesions, we evaluated in-hospital and long-term (1-year) clinical
outcomes in 117 consecutive patients treated with 3 coronary
stents compared with a concurrent series of patients treated with 1 or
2 stents (n=1673) between January 1, 1994, and December 31, 1995.
Multiple stents were implanted more often in larger vessels, in the
right coronary artery or saphenous vein grafts, and for
unfavorable lesion characteristics, including long (>20 mm),
calcified, ulcerated, thrombotic, and/or flow-obstructing lesions.
Overall procedural success was obtained in 97.4% of patients and was
similar whether 1 or 2 versus 3 stents were used. Non–Q-wave MI
(CK-MB 5 times normal) was more frequent after 3 stents (22.8%
versus 13.4%, P=.005). Target lesion
revascularization (TLR) was 14.6% for 1 or 2
stents and 13.3% for 3 stents (P=.70). There was no
difference in death (2.2% versus 0.9%, P=.34) or
Q-wave MI (1.4% versus 0.9%, P=.64) between the two
groups (1 or 2 stents versus 3 stents, respectively), and overall
cardiac event–free survival was similar during follow-up
(P=.70). 3) contiguous
stents compared with 1 or 2 stents have (1) similar in-hospital
procedural success and major complications despite having more
unfavorable lesion characteristics, (2) a higher rate of procedural
non–Q-wave MI, and (3) similar TLR and overall major cardiac event
rates during 1 year of follow-up.
Key Words: stents • coronary disease • angioplasty • restenosis
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