EFFECT OF THE IMPLANTED STENT LENGTH ON THE RESULTS OF CORONARY ANGIOPLASTY

S.A. Abugov, M.Y. Puretsky, Yu.M. Saakyan, O.V. Sankov, S.A. Davydov, A.Ye. Udovichenko, V.V. Kucherov, B.V. Shabalkin

Coronary angioplasty with implantacion of endovascular stents is currently widespread in interventional cardiology. It has been proven by many studies that both elective stenting and acute vascular occlusion performed at coronary angioplasty provide favourable immediate and longs term results. Numerous studies demonstrate the best angiographic and clinical results right after intervention and less percentage of restenosis development in the long-term period after coronary stenting as compared to coronary angioplasty. It is not yet clear, however, whether this applies to ail types of coronary artery lesions, particularly, to lengthy or tandem stenoses. The date obtained in the previous studies do not allow to form a judgement about the genuine impact of the stented segment length on the immediate and long-term results. Information pertaining to the relationship between the stent length and the incidence of restenosis is little and scanty. The present investigation has been undertaken to answer all these questions. The retrospective study accrued 177 patients who had undergone intracoronary stenting. There were 215 stenoses. All the patients were distributed into three groups as dependent on the stented segment length: group one (n=63) J20 mm, group two (n=59) >20 mm – J30 mm, group three (n=55) >30 mm. The patients in the groups were comparable in respect to all clinical parameters. Stent implantation was performed according to the generally accepted technique. Antiplatelet therapy included aspirin and ticlopidine. It was carried out in all group patients according to the unified accepted schedule. None of the groups developed complications such as transmural myocardial infarction and death. Acute thrombosis of the stent was recorded in two (3.6%) patients of the third group. As regards subacute thrombosis we felled to record significant difference between all three groups. Repeated catheterization was only provided to the patients with recurrence of the signs of myocardial ischemia. Restenosis in group one accounted for 4.8% (three patients), in group two for 8.5% (5 patients), and in group three for 25.4% (14 patients). Significant difference in restenosis development was noted between group one and group three patients. So, the length of the stented segment is an important factor influencing both immediate end long-term results of intracoronary stenting.

KEY WORDS: coronary angioplasty, coronary stenting, stent length.

P. 100-108

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