Angiographic and clinical follow-up after coronary implantation of the ACS Multilink Duet stent: a single center experience.

ABSTRACT

As a growing variety of coronary stents become available on the market and the results of randomised trials may be difficult to apply to less selected patients, detailed information about the immediate and long term results achieved with one device can be helpful for the interventional cardiologist. The purpose of the present study was to test the applicability, angiographic and clinical results of the ACS Multilink Duet coronary stent in a relatively unselected group of patients undergoing coronary angioplasty immediately and in the long term. From November 1998 to May 2000, 337 ACS Multilink Duet coronary stents were implanted in 285 patients in our clinic. Data were collected retrospectively from the catheterization laboratory records and patient charts. Restenotic lesions and chronic total occlusion stenting were excluded from analysis (45 patients and 60 stents were excluded leaving 240 patients, 262 lesions and 277 stents for analysis). In 3 cases (1%) the ACS Multilink Duet stent did not cross the lesion and another device was used. One patient (0.4%) died due to acute occlusion of the proximal left anterior descending artery and cardiogenic shock within 4 hours after the procedure. Three patients (1.25%) had subacute thrombosis and q wave myocardial infarction during the hospital course, while four additional patients, out of 197, in whom one month clinical data were available had myocardial infarction (2 q waves and 2 non-q waves) after hospital discharge in the first month (2.03%). After 6 months from the procedure angiographic follow-up data were available for 108 patients (45%), 111 lesions (42.4%) and 117 stents (40.4%). They had complex lesions, B2-C type accounting for 42.3% of the cohort, and lesions requiring 2.5 mm diameter stents were also included and constituted 11.1% of the study cohort. Restenosis occurred in 24 patients (21.4%) and in 25 stents (22.2%). Comparing the patients with and without restenosis, diabetes mellitus and complex lesion morphology (B2-C) were found to be more frequent in the restenosis group (p<0.01, p<0.01). Lesions suitable to stent with a stent diameter of 3.5 mm or more had less restenosis with respect to smaller diameters (p=0.022). For a single stent diameter restenosis rates, regarding the stent length were 14.2% for 8 mm and 13 mm, 18.6% for 18 mm, and 37.5% for 23 mm and 28 mm (p=not significant). The Multilink Duet stent, in a cohort of relatively unselected patients, has a high rate of applicability, an acceptable rate of subacute occlusion, and a low rate of restenosis.