Abstract 13696: Very Long-Term (15-23 years) Outcomes of Bare Metal Stenting and Plain Old Balloon Angioplasty
Background: Target lesion revascularization (TLR) continued to occur beyond 4 years after the bare metal stent (BMS) implantation after an apparent plateau phase between 1 and 4 years. However, long-term outcomes comparing plain old balloon angioplasty (POBA) with BMS are unknown.
Methods and Results: From Jan. 1989 to May 1990, 659 patients (748 lesions) underwent successful POBA with final balloon ≥3.0mm excluding the culprit lesion of acute myocardial infarction and were compared with 405 patients (424 lesions) with BMS implantation. Clinical follow-up information at 15 years was obtained in 529 patients (80%) in the POBA group and 327 patients (81%) in the BMS group, respectively. The cumulative incidences of all-cause death, cardiac death, composite of death and MI, and target lesion thrombosis (> 1year) were similar between the POBA group and the BMS group (44.4% vs. 45.4%, p = 0.60; 19.5% vs. 20.6%, p = 0.42; 51.8% vs. 51.6%, p = 0.88; 1.5% vs. 0.7%, p = 0.99; respectively). The cumulative incidence of TLR during overall follow-up was significantly higher in the POBA group compared with the BMS group (44.6% vs. 36.0%, p < 0.01), while the cumulative incidences of late TLR (> 4 years) tended to be lower in the POBA group than in the BMS group (16.3% vs. 21.4%, p = 0.16). The cumulative incidence of late TLR after POBA was significantly lower in patients with smaller percent diameter stenosis at the early follow-up angiography compared with those with larger percent diameter stenosis (14.5% vs. 28.0%, p = 0.02). In lesions with complete serial angiography, late lumen loss from the early (6-14 months) to the long-term (4-10 years) follow-up angiography was significantly smaller in the POBA group (n = 42) than in the BMS group (n = 55) (-0.08 ± 0.45mm vs. 0.11 ± 0.46mm, p = 0.047).
Conclusions: POBA as compared with BMS implantation was associated with a trend for less late TLR beyond 4 years and with significantly smaller late lumen loss from the early to the long-term follow-up angiography.
- © 2012 by American Heart Association, Inc.