Effects of stent length and lesion length on coronary restenosis

2004 ◽  
Vol 93 (11) ◽  
pp. 1340-1346 ◽  
Author(s):  
Laura Mauri ◽  
A.James O'Malley ◽  
Donald E. Cutlip ◽  
Kalon K.L. Ho ◽  
Jeffrey J. Popma ◽  
...  
Keyword(s):  
Lesion Length ◽  
Coronary Restenosis ◽  
Stent Length

scholarly journals PTA and Stenting of Femoropopliteal Trunk With Cordis Smartflex Stent System: A Single-Center Experience

2019 ◽  
Vol 54 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Luca Garriboli ◽  
Tommaso Miccoli ◽  
Gianguido Pruner ◽  
Antonio Maria Jannello
Keyword(s):  
Limb Ischemia ◽  
Primary Patency ◽  
Lesion Length ◽  
Acute Limb Ischemia ◽  
Vascular Stent ◽  
Stent Patency ◽  
Stent Occlusion ◽  
End Points ◽  
Stent System ◽  
Stent Length

Introduction: The aim of this study is to describe our experience in the treatment of femoropopliteal occlusive disease with percutaneous transluminal angioplasty (PTA) followed by stenting with S.M.A.R.T. Flex vascular stent system. Materials and Methods: From June 2014 to October 2018, 80 patients were treated at our Institution for intermittent claudication, critical, or acute limb ischemia due to total occlusion or long diffused lesions of the femoropopliteal segment. Main study end points are primary patency, target lesion revascularization, and stent fractures; secondary end points are major amputation rate, procedure-related bleeding, incidence of intrastent restenosis, and primary assisted patency after reintervention. Results: Mean follow-up time was 21 months (range 2-48 months). Primary patency rate was 80% (64 patients of 80), with mean covered lesion length of 8.2 cm. The deployment of a single stent was obtained for 57 (89%) patients, with a mean stent length of 9.86 cm. Of 80 patients, 2 (2.5%) had early stent occlusion within first 48 hours after the procedure, while 4 (5%) of 80 patients experienced stent occlusion within first 6 months. Of 80 patients, 6 (7.5%) had an intrastent restenosis detected at duplex ultrasound with a primary-assisted patency after simple re-PTA procedures of 83.3% at 12 months. Discussion: In the literature, primary patency after PTA and stenting of the femoropopliteal trunk seems to be related to several variables, such as number of stents used, specific stent length, diameters, type and length of lesions, type of pathology (if acute or chronic), and number of preoperatory patent below-the-knee vessels. In this study, we try to analyze each single factor in order to understand their role in predisposing specific stent restenosis. Conclusions: S.M.A.R.T. Flex vascular stent system has shown good results in terms of primary patency in the treatment of calcified lesions both at SFA and at popliteal level. However, in our experience, stent patency seems to be significantly poorer in patients presenting with acute limb ischemia associated with chronic atherosclerotic disease as well as for lesions located in the mid-distal part of the popliteal artery and both when number of stents increases or number of runoff vessel decreases.

Long-term results of the heparin-bonded Viabahn stent graft in femoropopliteal TASC C and D lesions with a covered stent length of minimum 25 cm

Vascular ◽  
2019 ◽  
Vol 27 (5) ◽  
pp. 553-559 ◽  
Author(s):  
C Uhl ◽  
A Dadras ◽  
F Reichmann ◽  
T Betz ◽  
N Zorger ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Stent Graft ◽  
Covered Stent ◽  
Long Term Results ◽  
Lesion Length ◽  
Secondary Patency ◽  
Graft Occlusion ◽  
Long Term Outcome ◽  
Stent Length

Background Heparin-bonded covered stent grafts (Viabahn) are used to treat femoropopliteal long-segment arteriosclerotic lesions. The aim of this study was to evaluate the long-term outcome of Viabahn grafts with a covered stent length of minimum 25 cm. Methods We conducted a retrospective analysis of patients receiving a heparin-bonded stent graft in our clinic who met the length criteria between July 2010 and March 2018. Primary endpoints were patency rates, limb salvage and survival after five years. Secondary endpoint was the 30-day outcome including early complications. Results A total of 62 patients (45 male, median age 70.5 years) were included. The median arteriosclerotic lesion length was 25 cm (22.0–41.3 cm), the minimum covered stent length was 25 cm (25–46 cm). All lesions were TASC C and D lesions. The 30-day mortality was 0%, an early stent graft occlusion occurred in 8.1%. A major amputation was performed in 1.6%. Primary patency, primary assisted patency, secondary patency, limb salvage and survival were 38.5%, 45.7%, 52.4%, 92.8% and 68.9% after five years. Distal stent graft end below the femoral condyles and critical limb ischemia was associated with a significant decreased survival. The diameter of the stent had no influence on the outcome. Conclusion The Viabahn stent graft for long segment arteriosclerotic lesions is a feasible treatment with adequate long-term results.

The impact of precise robotic lesion length measurement on stent length selection: Ramifications for stent savings

2015 ◽  
Vol 16 (6) ◽  
pp. 348-350 ◽  
Author(s):  
Paul T. Campbell ◽  
Kevin R. Kruse ◽  
Christopher R. Kroll ◽  
Janet Y. Patterson ◽  
Michele J. Esposito
Keyword(s):  
Length Measurement ◽  
Lesion Length ◽  
Stent Length ◽  
The Impact

scholarly journals In vivo measurement of stent length by using intravascular ultrasound

2019 ◽  
Vol 71 (1) ◽  
Author(s):  
Magdy Algowhary ◽  
Salma Taha ◽  
Hosam Hasan-Ali ◽  
Akihiko Matsumura
Keyword(s):  
Intravascular Ultrasound ◽  
Bare Metal Stent ◽  
Edge Length ◽  
Drug Eluting Stent ◽  
Elastic Membrane ◽  
Lesion Length ◽  
In Vivo Measurement ◽  
Longitudinal View ◽  
Stent Length

Abstract Background What happens to stent length when deployed in a coronary artery? It is the aim of this study. Results Consecutive 95 balloon-expandable stents (BES) were studied by intravascular ultrasound (IVUS) imaging. The stent length was measured from the longitudinal view in two ways: (1) edge-to-edge length (E-E) measured between distal and proximal stent frames located at one IVUS quadrant and (2) area-to-area length (A-A) measured between distal and proximal stent frames located at two or more IVUS quadrants. IVUS measurements were compared with the manufacturer-stated length (M-L). The median E-E length was significantly longer than M-L, 18.76 mm [interquartile range (IQR) 15.65–23.60] versus 18.00 mm (IQR 15.00–23.00), respectively, p < 0.0001. Also, the median A-A length was significantly longer, 18.36 mm (IQR 15.19–23.47), p < 0.0001, than M-L. Moreover, the E-E length was significantly different from A-A length, p < 0.0001. Among the stent groups, the differences were significantly present in all drug-eluting stent and bare metal stent (BMS) comparisons, p < 0.0001, except the A-A length versus M-L in BMS only. By multivariate analysis, the predictors of difference in stent length were as follows: lesion length, p = 0.01; pre-intervention minimal diameter of the external elastic membrane (EEM), p = 0.03; lesions present in the left anterior descending branch, p = 0.03; and M-L, p = 0.04. Conclusions In the present study, the length of BES measured by IVUS was significantly different from the manufacturer-stated length. In addition to the manufacturer length, other important factors such as lesion length, pre-intervention diameter of EEM, and affected vessel determine the stent length.

Abstract 2164: Impact of Sirolimus-Eluting Stent and Paclitaxel-Eluting Stent on the Outcome of Patients with Sirolimus-Eluting Stent Failure: Multicenter Registry in Asia

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Sunao Nakamura ◽  
Mizuki Hirose ◽  
Jang-Ho Bae ◽  
Yeo H Cahyadi ◽  
Wasan Udayachalerm ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Results ◽  
Lesion Length ◽  
Stent Length ◽  
Sirolimus Eluting Stent ◽  
Multicenter Registry

Purpose: To evaluate the Sirolimus-eluting stent (SES) and Paclitaxel-eluting stent (PES) on the outcome of patients with SES failure (SES-F). Methods: A total of 520 patients with 609 SES-F lesions (male 74.8%, mean age 72.1 yrs, LMT 7.1%, LAD 47.6%, LCX 25.0%, RCA 16.2%, SVG 4.1%) were treated with SES (mean lesion length 26.1±12.6 mm, mean stent length 31.3±15.9mm) and PES (mean lesion length 28.3±12.2 mm, mean stent length 32.9±19.3 mm). We evaluate immediate and long-term clinical results by 6 and 12 months angiography. Results: The baseline clinical characteristics between 2 groups were similar. See table for clinical results. Conclusion: The use of SES and PES in patients with restenosis after SES implantation was safe with low complications. Patients treated with SES showed lesser rate of restenosis compared with PES.

Arterial Preparation by Longitudinal Micro-Incisions Before Balloon Angioplasty of the Superficial Femoral and Popliteal Artery: Acute and 12-Month Results

2021 ◽  
pp. 152660282110570
Author(s):  
Jean-Baptiste Dexpert ◽  
Daniel Hayoz ◽  
Rolf P. Engelberger ◽  
Caroline Krieger ◽  
Marie-Antoinette Rey Meyer ◽  
...  
Keyword(s):  
De Novo ◽  
Arterial Disease ◽  
Target Lesion ◽  
Transluminal Angioplasty ◽  
Target Lesion Revascularization ◽  
Lesion Length ◽  
Stent Restenosis ◽  
Stent Length ◽  
Peripheral Arterial ◽  
Vessel Preparation

Purpose: Percutaneous transluminal angioplasty (PTA) with conventional plain old balloon (POBA) and/or drug-coated balloon (DCB) is the primary intervention to treat peripheral artery stenoses. However, acute dissections during the procedure and potential for future target lesion revascularization remain procedural complications. The purpose of this study was to assess the acute and 12-month outcomes in patients who underwent novel vessel preparation with longitudinal, controlled-depth micro-incisions prior to PTA. Materials and Methods: Patients with symptomatic lower extremity peripheral arterial disease with a Rutherford class of 2 to 6 and >70% de novo stenosis of the superficial femoral or popliteal arteries were included in this retrospective study. Patients with thrombotic or embolic lesions, restenosis, or in-stent restenosis were excluded. The FLEX Vessel Prep System (FLEX VP) was used to prepare the vessel prior to PTA by creating micro-incisions at the target lesion. The FLEX VP was followed by POBA or paclitaxel DCB. Results: The study included 65 patients. Lesion characteristics were 90% median stenosis (range = 70%–100%), 75.4% mild-to-severe calcifications, and 33.8% occlusion rate, and median lesion length was 196 (range = 10–480) mm. Following vessel preparation, 82.1% of the patients had low severity dissection or no flow-limiting dissection. The provisional stent rate postprocedure was 16.9%, with a median stent length of 60 mm. The freedom from target lesion revascularization (FFTLR) in 63 evaluable patients at 6 and 12 months was 98.4% and 93.7%, respectively. Freedom from amputation was 100%. Conclusion: In this real-world/all-comers patient population with long, stenotic lesions across the calcification spectrum, vessel preparation with longitudinal micro-incisions prior to PTA was associated with low dissection rate, low dissection severity, low stent implantation, and high FFTLR with the absence of amputation at 12 months relative to published reports in long-lesion cohorts. These results support vessel preparation via micro-incisions.

scholarly journals Study Comparing Coronary Stenting in Smaller Vessels Versus Large Vessels

2017 ◽  
Vol 02 (01) ◽  
pp. 014-019
Author(s):  
Harish Oruganti ◽  
Indrani Garre ◽  
Bharathi Vanaparty ◽  
Sreekanth Yerram
Keyword(s):  
Chronic Stable Angina ◽  
Coronary Vessels ◽  
Group Versus ◽  
Region Of Interest ◽  
Large Vessel ◽  
Small Vessel ◽  
Lesion Length ◽  
Lv Dysfunction ◽  
Stent Length ◽  
One Year

AbstractBackground: Smaller vessel PTCA account to approximately on third of all PTCA worldwide. With increasing incidence of diabetes mellitus and aging, this proportion can increase considerably. This is a region of interest for us because Indians, in particular, are known to have smaller coronaries. There are limited studies in coronary vessels < 2.5 are available. Most of the previous studies defined small vessel as < 3 or 2.75 mm.Methods and Results: This is an observational single center study where we analyzed 650 patients, 52 in the small vessel group(< 2.5 mm) and 598 in large vessel group(≥ 2.5 mm) with similar mean age between the both the groups (57.5±11.4 vs 57.9±11.1 yrs). Hypertension and smoking are more in large vessel group (74.7% vs 61.9, p=0.004; 22.1% vs 13.4%, p=0.007), whereas no difference for presence of diabetes (54.2% vs 54.3%) or type of CAD (CSA – chronic stable angina – 70.3% vs 76.1%, p=0.2). Large vessel group patients had more LV dysfunction (40.3% vs 24.6%, p=0.000).Mean Pre reference diameter was 1.9±0.5mm in small vessel group versus 2.9±0.5mm in large vessel group. Mean minimum lesion diameter in small vessel group is 0.8±0.3 mm versus 1.3±1.9 mm in large vessel group. Mean pre-lesion length is 16.7±3.5 mm in small vessel group versus 18.3±8.3mm in large vessel group. Mean stent size is 2.33mm in small vessel group versus 3.04mm in large vessel group. Mean stent length is 17.27mm in small vessel group versus 21.8mm in large vessel group. The success of PCI in small vessel group was 96% (not able to deliver stent in one patient and in one patient there was a non-flow limiting distal stent dissection) and 98% in large vessel group.In one year follow-up, 5 (3.5%) patients from small vessel group and 34 (4.5%) patients from large vessel group had MACCE which is not statistically significant (p=0.6)Conclusions: Small vessel (really small means less than 2.5 mm) PCI, not only acute but also one-year results are good with MACCE rate of 3.5% and comparable to large vessel PCI.

Clinical outcomes after percutaneous coronary intervention in patients with and without history of diabetes mellitus with different stent size

2020 ◽  
Author(s):  
Mohammad Javad Zibaeenezhad ◽  
Mehrab Sayadi ◽  
Seyyed Saeed Mohammadi ◽  
Soorena Khorshidi ◽  
Ehsan Hadiyan ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Clinical Outcomes ◽  
Stable Coronary Artery Disease ◽  
Coronary Intervention ◽  
Lesion Length ◽  
Diabetic Patients ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Stent Length ◽  
History Of

Abstract Background There are different reports on the occurrence of post-revascularization outcomes of diabetic patients in previous studies. Lesion complexity, which is reflected in stent size, influences the occurrence of outcomes. The aim of the present study was to investigate the occurrence of clinical outcomes in patients with history of diabetes (hDM) after percutaneous coronary intervention (PCI) with emphasis on stent length and diameter. Methods In a retrospective single-center cohort approach, among patients with stable coronary artery disease who underwent PCI with first- and second-generation DES, subjects were included from 2003 until 2019. Outcomes including revascularization, myocardial infarction, and death, totally defined as major adverse cardiac events (MACE), were sought in follow-up phase. All the patients whether with and without hDM received aspirin and clopidogrel as DAPT for at least two years and one year, respectively. Results About 29% out of 1630 participants had hDM and 37.8% of patients who experienced MACE had hDM. Unlike age and time-to-event, there was significant difference in gender between hDM and non-hDM groups. However, no difference was seen in type of MACE between these two groups. Also, after adjusting confounder variables, there was no significant difference in MACE incidence between hDM and non-hDM groups with different stent length and diameter (different lesion length and diameter). Conclusions hDM did not affect MACE incidence significantly in different stent length and diameter. We think that using of DES supplemented by long term DAPT and tight control of glycemic status after PCI are the underlying reasons.

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