Long-term follow-up study of coronary reconstruction with multiple stents

Background Conventional balloon angioplasty of very long de novo coronary l esions or very long coronary dissection caused by angioplasty is associated with low success and high complication rates. Multiple intracoronary stent s have been used to treat both conditions, although long-term efficacy has not been defined. Methods and Results Between June 1993 and December 1995, 47 consecutive pat ients underwent native coronary angioplasty and stenting with 4 or more ste nts covering at least 2 consecutive diseased coronary segments. Preangiopla sty and poststenting diameter stenoses were 81% +/- 13% and 21% +/- 12%, re spectively Reference vessel diameters were 3.53 +/- 0.55 mm proximal to the stents and 2.95 +/- 0.62 mm distal to the stents. Average lesion length wa s 63 +/- 20 mm. The number of stents used was 4.5 +/- 1 per vessel (from 4 to 7). Gianturco Roubin I stents were used in all patients. Coronary Palmaz -Schatz stents were used as supplementary stents in 3 patients. Angiographi c success was 100%. In-hospital outcomes include 1 death, 1 coronary bypass surgery, no Q-wave myocardial infarction, and 7 non-Q-wave myocardial infa rctions. long-term follow-up at 430 +/- 199 days was completed in all patie nts. Thirty-five (76%) patients were asymptomatic, 8 (17%) had class 1 or 2 angina, 1 had a myocardial infarction, 13 (28%) underwent repeat angioplas ty, 2 patients had subsequent elective bypass surgery, and 3 died during fo llow-up. Conclusions Multiple intracoronary stents for very long lesions or dissecti on can be performed with acceptable immediate and long-term outcomes.