Results (> 6 months) of stenting of > 1 major coronary artery in multivessel coronary artery disease

Multivessel percutaneous transluminal coronary angioplasty (PTCA) is associ ated with a high requirement for further revascularization procedures. Alth ough stenting can reduce restenosis and clinical events after 1-vessel inte rvention, little information is available after multivessel coronary stenti ng. We followed up 136 patients (9% of 1,481 undergoing stenting in our cen ter) who had had stent implantation in at least 2 different major native co ronary arteries and were followed-up for >6 months. Each patient had receiv ed a mean of 2.3 +/- 0.6 stents (1.13 +/- 0.4 stents per lesion) and proced ural success was 95%, In-hospital complications included 1 death, 1 Q-wave infarction, 5 non-Q-wave myocardial infarctions, and 1 repeat PTCA. After a mean of 18 +/- 13 months, 7 patients died (3 of heart failure, 4 of noncar diac causes), 2 required coronary bypass surgery, 1 had a myocardial infarc tion 13 target vessel repeat PTCA, and 4 non-target vessel PTCA. Survival f ree of major cardiac events was 75% at 3 years. A history of heart failure, dilation of a restenotic lesion, and 3-vessel dilation were independent ne gative predictors of event-free survival. Angiographic follow-up was availa ble in 86 patients: 56 (65%) were restenosis free, 23 (27%) had 1-vessel re stenosis, and 6 (7%) had 2-vessel and 1 patient 3-vessel restenosis. Resten osis per vessel was 23% (41 of 177). Reference diameter, post-PTCA minimal luminal diameter, and length of the stent were independent predictors of re stenosis. We conclude that multivessel stenting provides good midterm resul ts in selected patients with multivessel coronary artery disease. Midterm e vents are less frequent than previously reported after balloon PTCA. (C) 19 99 by Excerpta Medica, Inc.