Acute and long-term clinical and angiographic outcomes of coronary stenting using Palmaz-Schatz stent and ACS Multi-Link stent

Abstract

Acute and long-term (>/= 3 years) outcomes of coronary artery stenting using Palmaz-Schatz and Multi-Link stent implantations between November 1995 and October 1999 were analyzed. There were 655 Palmaz-Schatz stent implantations in 577 lesions on 477 patients (group A) and 428 Multi-Link stent implantations in 381 lesions on 326 patients (group B). The baseline characteristics were similar in the two groups. Group B had more complex lesions, longer stenotic lesions, and larger reference vessel sizes than group A. However, both groups had a similar in-hospital cardiac events. Four hundred and two patients with 488 lesions in group A and 260 patients with 307 lesions in group B underwent a 6-month follow-up coronary angiography. The restenotic rate per lesion was 16% in both groups (P = 0.872). A 3-year angiographic follow-up was performed in 262 patients of group A (301 lesions) and 139 patients of group B (162 lesions), and restenosis was noted in only 3 patients (1.36%) in group A and 5 patients (4%) in group B, in which the lesion was patent at the 6-month angiographic follow-up. Significant increase in minimal luminal diameter was noted from 2.23 +/- 0.66 mm at 6 months to 2.33 +/- 0.64 mm in group A (P < 0.01), and insignificant increase from 2.23 +/- 0.77 to 2.28 +/- 0.82 mm was noted in group B (P = 0.27). No differences were noted between the two groups in mortality, reinfarction, recurrent angina, target lesion angioplasty, or elective coronary artery bypass surgery during a follow-up period of 60 +/- 3 months. Forty-five patients (9.4%) in group A and 18 patients (5.5%) in group B received additional stenting procedures for newly developed lesions. The overall cardiac event-free survival was 66% in group A and 72% in group B (P = 0.844). In conclusion, the procedural success rate, in-hospital morbidity, 6-month angiographic results, and long-term (>/= 3 years) clinical and angiographic outcomes were similar with coronary stenting using either Palmaz-Schatz or Multi-Link stent. The stented lesions were stable; however, late regression of minimal luminal diameter was noted in both groups, and progression of atherosclerotic change in the nonstented site was noted during long-term follow-up.