Abstract:
Actuality: In-stent restenosis (ISR) is considered most important complication of the
percutaneous transluminal coronary angioplasty (PTCA). For a period of six months, the prognosis
of PTCA varies in dependence of what method is used: it occurs in over 45-50% of cases after
balloon angioplasty, in 10-15% after the use of bare metal stents (BMS) the result being better and
below 10% after the use of drug eluting stents (DES).
The aim: To elucidate the impact of coronary stent's length in ISR occurrence in patients
with various forms of IHD, after a 6 months follow-up.
Material and Methods: In this study were involved 150 patients. According to the stent's
length, the group was divided into 2 subgroups: group I - subgroup I - that of “long” stents
(>20mm) - 64 patients and subgroup II - that of “short” stents (<20mm) - 86 patients. Patients
underwent clinical supervision for a period of 6 months.
Results: In order to solve these lesions in the patient's groups were used several models of BMS.
In both groups the model “Driver/Integrity” was used more often - 44.2% in group I and 39.1% in
group II. On the second stage were placed “Vision” stents model which were used in 33.7% cases of the
“short stents” group and in 35.9% cases of the “long stents” group. “Liberte” were used in the treatment
of 22.1% patients from the Ist group and of 25% patients from the IInd group. After a 6 month follow-up
IRS confirmed angiographically had 10.5% patients in whose treatment were used “short” BMS and
20.3% patients in whom were implanted “long” BMS, while in 8.1% patients the Ist group and 15.6%in
the IInd group were diagnosed new injuries, due to this fact they suffered repeated angioplasty
procedures, the obvious differences being statistically relevant one - p <0.05. The lumen loss index was
more important for long stents - 2.54 vs. 2.33mm (p <0.05).
Conclusions:
1. Bare metal stents whose length is <20mm have a favourable prognosis at a 6 month
distance compared to those >20mm, in-stent restenosis rate in this period was 10.5% for short stents
and 20.3% for those long.
2. It is necessary to choose an optimal length by using bare metal stents - so that the stent's
borders not to exceed long away the coronary lesion, but for cases that require the use of stents
>20mm is more beneficial to use drug eluting stents.
3. It is advisable to avoid the use of bare metal stents in the treatment of coronary lesions
with those lengths more than 20mm, in these cases drug eluting stents are of choice, while in the
cororarian lesions with their length <20mm treatment, bare metal stents can be used widely.
Description:
Cardiology Department, State University of Medicine and Farmacy “Nicolae Testemitanu”, Chisinau, Republic of Moldova
