Stent Implantation Results in Long Lesions and Small Coronary Vessels

Background: Data on the outcomes of stent implantation in long lesions (28 mm) in small (2.5 mm) coronary vessels is limited.Aim: To investigate the acute outcomes of stenting in long and small coronary lesions.Study Design: Retrospective cohort study. Methods:Patients with stable coronary artery disease or acute coronary syndrome (ACS) who had undergone percutaneous coronary revascularization to native coronary arteries with stents 2.5 mm in size and 28 mm in length were assessed.Post-procedural analyses were performed with using Quantitative Coronary Analysis software system to evaluate stent oversizing.Acute complications, such as edge dissection and distal thrombus embolism were also recorded.Results: A total of 161 consecutive patients (127 male, mean age: 62.79.0 years) were included.Most of the lesions were mid or proximal segments of the coronary arteries.Edge dissection was detected in 30 patients.Stent oversizing and reduced post-procedural TIMI flow grade were significantly higher in patients with edge dissection.Stent oversizing emerged as an independent predictor of edge dissection, with oversizing of >25% compared to the distal vessel diameter predicted edge dissection with a sensitivity of 83.3% and specificity of 80.2%.In addition to edge dissection, distal embolism was more frequently observed in procedures with stent oversizing.TIMI flow grade 1-2 rates were found to be significantly higher in patients presenting with ACS. Conclusion:Stenting in long lesions with small sized stents is related to a high risk of edge dissection, especially in procedures involving stent oversizing.