INITIAL EXPERIENCE WITH LONG CORONARY STENTS - THE CHANGING PRACTICE OF CORONARY ANGIOPLASTY

The initial experience with the use of long coronary stents (>30 mm in length) was analyzed retrospectively. Sixty-seven stents were deploye d in 58 narrowings in 57 patients (34 AVE Microstents, 16 Nir stents, four Gianturco-Roubin II stents, and 13 Wallstents). Stents were impla nted in 22 patients with unstable angina, 34 patients with stable angi na, and one patient during direct angioplasty For acute myocardial inf arction. Eighteen additional short stents were implanted to cover the entire length of the lesions so that an average of one and a half sten ts were deployed per patient. The length of the narrowings before sten ting was 40 +/- 20 mm and the length of the scented segments was 45 +/ - 20 mm. Stents were deployed for ''bailout'' in 23 narrowings, to imp rove suboptimal results of balloon angioplasty in 18 narrowings, and e lectively in 17 narrowings, Twenty of the 67 long stents were deployed in saphenous vein grafts. The success rate of stent implantation was 100%. One patient had a rupture of a saphenous vein graft after deploy ment of two long stents, with tamponade treated by emergency surgery. One patient had chest pain 18 hours after stent deployment; by the tim e he arrived at the catheterization laboratory the pain had subsided a nd the angiogram revealed a patent artery with normal flow. There were no other major complications during the hospital course and 1-month f ollow-up. We conclude that long coronary stents can be deployed succes sfully in native coronary arteries and vein grafts, They are useful fo r elective implantation and extremely helpful in bailout situations. T he immediate results are excellent, but long-term outcome is awaited.