The influence of stent length on clinical and angiographic outcome in patients undergoing elective stenting for native coronary artery lesions: Final results of the Magic 5L Study

D. P. Foley, M. Pieper, W. Wijns, H. Suryapranata, G. Grollier, V. Legrand, I. De Scheerder, C. Hanet, J. Puel, H. Mudra, H. J.R.M. Bonnier, A. Colombo, M. Thomas, P. Probst, M. C. Morice, J. Kleijne, P. W. Serruys

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Résumé

Aims: To prospectively evaluate the influence of stent length on 6 month clinical and angiographic outcome, in patients with native coronary lesions up to 45 mm in length, undergoing elective Magic Wallstent implantation. Methods and Results: On the basis of pre-procedural angiography, 276 patients (aged 61.3 ± 10.2 years; 78.6% male; 41.7% unstable angina) with a total of 302 lesions were prospectively assigned to one of five different length categories of Magic Wallstent. Angiography in multiple matched projections before and after implantation and at 6 months follow-up was analysed at the core laboratory. Primary end-points for the efficacy analysis were cumulative incidence of major adverse cardiac events and quantitative coronary angiography analysis 6 months after stent implantation. Magic Wallstent implantation was successful in 301 of 302 lesions and in 98.6% a residual stenosis <20% by online quantitative coronary angiography was achieved. At 30 days, 6.2% (1.8% subacute occlusion) of patients had experienced major adverse cardiac events, 27.5% at 6 months and 30.4% at 9 months. Angiographic restenosis occurred in 37%. Restenosis rates for the mini, extra-short, short, medium and long Wallstent groups were 25.9%, 25%, 22.6%, 36.2% and 67.5%, respectively. Multivariate analysis revealed stent length to be independently associated with greater angiographic restenosis and major adverse cardiac events. Conclusions: While shorter Magic Wallstents provided late outcomes comparable with short balloon-expandable stents, excessive restenosis with longer Wallstents should obviate their use in elective percutaneous intervention. Long coronary lesions provide a challenging substrate for emerging antirestenosis therapies, such as stent coatings and brachytherapy.

langue originaleAnglais
Pages (de - à)1585-1593
Nombre de pages9
journalEuropean Heart Journal
Volume22
Numéro de publication17
Les DOIs
Etat de la publicationPublié - 12 sept. 2001
Modification externeOui

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