Abstract 3344: Long-Term Clinical Outcome of Treating Long, Diffuse (>30mm) Lesions with Sirolimus-Eluting Stent.: From One-Year Clinical Outcome Of the j-Cypher Registry
(Background) In the bare metal stent (BMS) era, long coronary lesions were associated with high restenosis rates after optimal stent implantation. The aim of this study was to evaluate the effectiveness of sirolimus-eluting stents (SES) implantation for diffuse long (>30mm) coronary lesions.
(Method)Design of the j-Cypher Registry was multi-center prospective enrollment of consecutive patients (pts) receiving SES from 41 centers in Japan. By the end of March, 2007, one-year clinical follow-up data were available in 9853 pts (14890 lesions) underwent successful implantation of SES. Among them, 644 pts (992 lesions) were treated with exclusive SES in the long diffuse (lesion length>30mm), de-novo native coronary lesion in the elective procedure.
(Results) The mean age was 68±10 years. 291 pts (45.2%) had diabetes (DM) (12.3% insulin treated), 326 pts (50.6%) had renal insufficiency (Creatinine Clearance: Ccr <60 ml/min) (5.1% hemodialysis). The mean number of stents per lesion was 2.2±0.7, and the average stented length and lesion length were 52.6±17.7mm and 43.8±12.6mm. At one-year follow-up, TLR was observed in 7.7% of the lesions. One-year clinical outcomes are shown in the table⇓. In the multivariate analysis, hemodialysis and stenting involved left main coronary artery (LMCA) were the significant predictor of one year restenosis with a relative risk of 3.6 and 6.5.
(Conclusion) Although the lesions and patients had high risk of restenosis, this data suggest that SES implantation for long coronary stenosis is considered to be safe and effective at one-year follow-up. The predictors of restenosis by multivariate analysis were hemodialysis and LMCA stenting.