Long-term (> 3 years) clinical and angiographic outcomes of coronary multilink stent implantations: a single center experience.

The ACS Multilink (ML) stent is a novel second-generation stent. The largest amount of information available on the long-term outcome of coronary stenting is based on the use of Palmaz-Schatz stents. Fewer data exist on long-term follow-up results of ML coronary stents implantations. The authors present the long-term (> 3 years) clinical and angiographic follow-up results of the ACS Multilink coronary stents implanted in their institution. From May 1996 to December 1997, 125 patients underwent 133 coronary ML stent implantations. Stented vessels were as follows: 49% left anterior descending artery, 31% right coronary artery, and 20% left circumflex coronary artery. Indications for stent implantations were elective in 64%, because of suboptimal result from percutaneous transluminal coronary angioplasty (PTCA) in 26%, and bailout from PTCA in 10% of patients. The mean reference diameter of stented vessels was 3.2 +/- 0.2 mm. The mean percentage stenosis was 80 +/- 11% and 3 +/- 5% before and after stent implantation, respectively. Long-term clinical follow-up was completed in 75% (80 men, mean age 53 +/- 10 years) of the patients (either by interview or phone), and angiographic follow-up (37 +/- 12 months) was completed in 58% of the patients. There were no baseline clinical or angiographic differences between those angiographically followed up and the remaining patients. Angiographic restenosis (> 50% diameter stenosis) was detected in 22% of stents. Target lesion revascularization was 12%, nontarget lesion revascularization was 14% in angiographically followed up patients. During the follow-up period death and new myocardial infarction occurred in 12% and 6% of patients, respectively, and survival rate was 88%. This study provides long-term follow-up results of intracoronary Multilink stent implantations for native coronary artery lesions. These data show that clinical and angiographic benefits of ML stents are comparable to those of the first-generation stents, especially to the Palmaz-Schatz stents, of which results have been reported previously. A considerable rate of nontarget lesion revascularization occurs during the follow-up period.

Long-term (3-5 years) clinical and angiographic follow-up results of coronary stenting in elderly patients.

The early and late results of percutaneous transluminal coronary angioplasty in elderly patients are well known, but although stent implantation has become the most frequent percutaneous coronary intervention in many centers, little information exists about its long-term outcome in elderly patients. The aim of this study was to evaluate the long-term clinical and angiographic follow-up results of intracoronary stenting in a study cohort of 120 patients (92 male) over 65 years of age, who underwent successful coronary stenting between June 1995 and December 1997. The target coronary artery was 48% left anterior descending, 21% circumflex and 31% right coronary artery. Stent implantation was elective in 54%, suboptimal in 32% and bailout in 14% of the patients. Long-term (34+/-14 months) clinical and angiographic follow-up was completed in 78% and 56% of the patients, respectively. The following end-points were considered: death, non-fatal myocardial infarction (MI), target and non-target lesion revascularization. Angiographic restenosis was detected in 31% of the patients. During the long-term follow-up period, 14% of the patients died and 11% developed a new MI. Target lesion revascularization was done in 19.4%, non-target lesion revascularization was done in 21%, and the survival rate was 86%. Although the restenosis rates did not deviate greatly from the expected long-term figures in younger populations, they do indicate that the potential for major cardiac events is still high among elderly subjects, in spite of developments in stent technology and medication.