Multiple versus single drug-eluting stenting in patients with small coronary lesion

초록

Background: Percutaneous coronary intervention (PCI) in patients (pts) with small vessel and diffuse disease is challenging because of the higher chance of recurrence even in the drug-eluting stent (DES) era. The efficacy and safety of multiple DES implantations in pts with diffuse long and small vessel is largely unknown. Methods: From Sep, 2004 to Dec 2006, a total 104 pts with small vessel (diameter≤2.50 mm), de novo coronary artery lesions were treated with DES. Two or more DESs were implanted in 24% of the enrolled pts. Mid-term angiographic outcomes, clinical outcomes, and the survival and freedom from MACEs of the Multi-stenting group (25 pts, 53 lesions) were compared with those of Single stent group (79 pts, 79 lesions). Results: In this study, 25 pts received two or more DESs (DES/pt=2.12 ± 0.33). The baseline characteristics were matched between the two groups. The percentage of precedure success was high and there was no difference between the two groups (100% vs. 97.3%, P=0.517). At 6-month, the overall incidence of binary restenosis was in 23.1%. However, there was no significant difference between the two groups. Overall clinical outcomes were similar (Table) and during the 6-month follow up, the survival and freedom from MACEs was similar between DM and non DM group (96.0% vs. 96.2%, p=1.000). Conclusion: Multiple DES implantations in pts with small vessels and diffuse long disease are safe and effective. Although the implanted stent number might not impact on the survival and freedom from MACEs after PCI at mid-term follow up, but the incidence of binary restenosis remained high, which need long-term follow up with larger study population.