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(Circulation. 2002;105:2986.)
© 2002 American Heart Association, Inc.

Clinical Investigation and Reports

Long-Term Clinical and Angiographic Follow-Up After Coronary Stent Placement in Native Coronary Arteries

Takeshi Kimura, MD; Kenichi Abe, MD; Satoshi Shizuta, MD; Keita Odashiro, MD; Yoshinori Yoshida, MD; Koyu Sakai, MD; Kazuaki Kaitani, MD; Katsumi Inoue, MD; Yoshihisa Nakagawa, MD; Hiroyoshi Yokoi, MD; Masashi Iwabuchi, MD; Naoya Hamasaki, MD; Hideyuki Nosaka, MD; Masakiyo Nobuyoshi, MD

From the Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.

Correspondence to Masakiyo Nobuyoshi, MD, Department of Cardiology, Kokura Memorial Hospital, 1-1 Kifune-machi, Kokurakita-ku, Kitakyushu, 802, Japan. E-mail kmhptca{at}nn.iij4u.or.jp

Background— Although coronary stents have been proved effective in reducing clinical cardiac events for up to 3 to 5 years, longer term clinical and angiographic outcomes have not yet been fully clarified.

Methods and Results— To evaluate longer term (7 to 11 years) outcome, clinical and angiographic follow-up information was analyzed in 405 patients with successful stenting in native coronary arteries. Primary or secondary stabilization, which was defined as freedom from death, coronary artery bypass grafting, and target lesion-percutaneous coronary intervention (TL-PCI) during the 14 months after the initial procedure or after the last TL-PCI, was achieved in 373 patients (92%) overall. Only 7 patients (1.7%) underwent TL-PCI more than twice. After the initial 14-month period, freedom from TL-PCI reached a plateau at 84.9% to 80.7% over 1 to 8 years. However, quantitative angiographic analysis in 179 lesions revealed a triphasic luminal response characterized by an early restenosis phase until 6 months, an intermediate-term regression phase from 6 months to 3 years, and a late renarrowing phase beyond 4 years. Minimal luminal diameter in 131 patients with complete serial data were 2.62±0.4 mm immediately after stenting, 2.0±0.49 mm at 6 months, 2.19±0.49 mm at 3 years, and 1.85±0.56 mm beyond 4 years (P<0.0001).

Conclusions— The efficacy and safety of coronary stenting seemed to be clinically sustained at 7 to 11 years of follow-up. However, late luminal renarrowing beyond 4 years was common, which demonstrates the need for further follow-up.

Key Words: stents • restenosis • angioplasty

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