Immediate and Long Term Outcome of Single Long Stent for Long Complex Coronary Artery Stenosis Compared to Multiple Conventional Stent

Coronary stenting for long complex lesion is effective but associated with complication. We compared the results of stenting between with multiple conventional stenting group (group A) and with single long stenting group (group B). Fifty patients were prospectively and randomly enrolled: 25 patients for each group. Each group showed no significant differences of clinical characteristics. One patient died of heart failure in each group, not associated with the procedure itself. One patients had cerebrovascular accident in each group. Five patients had major bleeding (2, group A; 3, group B). Angiographic success rate was 100% in each group and procedural success rate was 96% and 100% in group A and B, respectively. Angiographic and clinical restenosis rate at 6 months follow-up were 60%, 36% in group A and 65%, 44% in group B, respectively (p=S). Multivariate analysis showed that several factors affected the angiographic restenosis rate as follows; a) male gender (M:F=76.9%:25.0%, P<0.001), b) AMI (AMI:stable angina pectoris=72.7%:66.7%, P<0.001), c) lesion length d) residual stenosis. In conclusion, there were no statistical differences of restenosis and complication rate between the two groups. Our data support single long stenting is acceptable and economically more favorable for long diffuse lesion, compared to multiple conventional stenting.

A Case of Congenital Insensitivity to Pain with Anhidrosis

Congenital insensitivity to pain with anhidrosies (CIPA) is one of the exceedingly rare hereditary sensory autonomic neuropathies (HSAN). There are five types of HSAN according to hereditary transmission, natural history, clinical manifestations, and pathologic findings. The CIPA corresponds to type IV and is characterized by episodes of recurrent fever with generalized anhidrosis, insensitivity to pain and temperature with self-multilation, and mental retardation. We report a 14 month old girl with the clinical symptoms and neuropathological findings of CIPA without family history. She presented with episodes of recurrent fever and self-mutilation of her tongue. Clinical, laboratory and pathologic aspects of this patient are discussed along with review of the literature.