Predictive Factors for the Restenosis after Long Coronary Stent Implantation

ABSTRACT

BACKGROUND AND OBJECTIVES: In-stent coronary restenosis remains one of major clinical problems in percutaneous coronary intervention. Long stent has been known to be associated with high restenosis rate. Predictive clinical and angiographic factors were analyzed after long coronary stenting. METHODS: One hundred four patients (57.2+/-9.6 year-old, 105 male) who underwent long coronary stent implantation and follow-up coronary angiogram, out of 237 patients implanted long coronary stents between June 1996 and January 1999 at Chonnam National University Hospital. RESULTS: Primary success rate was 100%. Lesion length was 18.5 +/- 9.2 mm and the length of stent was 27.3 +/- 6.1 mm. Mean duration of clinical follow-up and follow-up coronary angiogram was 20.1+/-6.8 months and 6.3+/-2.7 months respectively. Restenosis rate according to follow-up coronary angiogram was 42.5% (57/134). Clinical variables of age, sex, clinical diagnosis, risk factors, and angiographic variables of target artery and lesion types, indications for stenting, stent types, reference diameter, lesion length, minimal luminal diameter, and acute gain were not related with late stent restenosis. Diameter stenosis before stenting was higher in the group with restenosis (81.9+/-16.9 %) than in group without restenosis (71.1+/-18.5%; p<0.05), and lower lower in the group with restenosis (-7.6+/-15.7%) and in the group without restenosis (5.6+/-22.4%; p<0.05) after stenting. CONCLUSIONS: Primary success rate was comparable. Severe luminal stenosis before stenting and overdilation after stenting are associated with restenosis after long coronary stenting.