Long Coronary Lesions: Challenging Cases for Percutaneous Coronary Intervention

Julio Núñez,Juan Sanchis,Gema Miñana

doi:10.4236/ijcm.2016.71008

Abstract

Long coronary lesions are associated with adverse outcomes after percutaneous coronary intervention since the era of plain balloon angioplasty. Long lesion and long stent length are considered as important predictors of restenosis after percutaneous coronary intervention. With the advent of newer generation drug eluting stents, there has been dramatic reduction in the rates of restenosis and repeat revascularization, even in complex cohort of patients with long coronary lesions. We report one such case of long coronary lesion which was intervened successfully with newer generation, thin strut, biodegradable polymer coated sirolimus-eluting stents.

Highlights

The treatment of long and diffuse coronary lesions remains a challenge for interventional cardiologists, since the era of balloon angioplasty
Even in the bare metal stents (BMS) era, implantation of multiple and long stents resulted in higher incidence of diffuse in-stent restenosis [2]
Technical advances in development of new stents such as thin strut, biodegradable polymer coated sirolimus-eluting stents have encouraged manufacturers to fabricate long stent platforms with the aim to increase the success of percutaneous revascularization avoiding multiple overlapping stents

Summary

Introduction

The treatment of long and diffuse coronary lesions remains a challenge for interventional cardiologists, since the era of balloon angioplasty. Initial experience with first DES, Cypher sirolimus-eluting stents demonstrated that despite the reduction of clinical events, deployment of multiple overlapping stents for long lesion, an approach colloquially called as “full-metal jacket”, is an approach with some risks [4]. Technical advances in development of new stents such as thin strut, biodegradable polymer coated sirolimus-eluting stents have encouraged manufacturers to fabricate long stent platforms with the aim to increase the success of percutaneous revascularization avoiding multiple overlapping stents. We report one such case of long coronary lesion which was intervened successfully with a long newer generation, thin strut, biodegradable polymer coated sirolimus-eluting stents

Case Report

Findings

Discussion