Indian Journal of Science and Technology

Abstract

Objectives: Stent length is an important predictor of adverse events after PCI. The study was aimed to evaluate the clinical outcome of long stent length. Methodology: The present one year prospective study included 660 consecutive patients who underwent long segment elective coronary artery stenting from April 2012 and March 2013. The patients were divided into three cohorts depending upon the stent length 24-28 mm, 29-32 mm and more than 32 mm. Study endpoint was Major Adverse Cardiac Events (MACE) including cardiac death, myocardial infarction, repeat revascularization and stent thrombosis. Results: The commonest age group was 51 to 60 years (45.91%) of the 660 patients, 211 (31.97%) had stent length between 24 to 28 mm, 198 (30%) had 29 to 32 mm and 251 (38.03%) had > 32 mm. Risk factors including hypertension, diabetes mellitus, smoking, dislipidemia, obesity, family history and cerebrovascular accident were comparable in patients with different stent lengths (p>0.050). Significantly higher number of patients with 32 mm stent length had overlapping, dissection and direct stenting (p<0.050). Overall MACE was significantly high in patients with stent length >32 mm (p=0.045) but no statistically significant difference was observed on comparison of individual variables (p>0.050). Also comparable outcomes were noted in patients with diabetes mellitus and without diabetes mellitus (p>0.050). Conclusion and Interpretation: Use of more than 32mm Drug Eluting Stent (DES) for the treatment of long lesions results in overall high MACE rate.

Keywords:
Coronary Artery Disease, Drug-Eluting Stents, Major Adverse Cardiac Events (MACE), Percutaneous Coronary Intervention, Stent Length