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Reviews in Cardiovascular Medicine  2021, Vol. 22 Issue (3): 931-938     DOI: 10.31083/j.rcm2203101
Special Issue: State-of-the-Art Cardiovascular Medicine in Asia 2021
Original Research Previous articles | Next articles
Comparison of standard versus modified stenting technique for treatment of tapered coronary artery lesions
Dan Ke1, 2, †, Xi He1, 2, †, Chaogui Lin1, 2, Lianglong Chen1, 2, *()
1Department of Cardiology, Fujian Medical University Union Hospital, 350001 Fuzhou, Fujian, China
2Fujian Institute of Coronary Artery Disease, 350001 Fuzhou, Fujian, China
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Abstract:
Tapered coronary artery lesions (TCALs) are often seen clinically, optimal stenting of TCALs remains challengeable. This study sought to compare clinical outcomes between the modified single stenting (MSS) and conventional overlapped stenting (COS) in treatment of TCALs. 150 patients were treated with MSS (MSS group), another 150 patients were matched with propensity score matching from 5055 patients treated with COS (COS group). Quantitative coronary angiography was performed to measure minimal lumen diameter (MLD), late lumen loss (LLL). The primary endpoint was immediate angiographic success, one-year cumulative major cardiac adverse events (MACEs) composing cardiac death, target vessel myocardial infarction (TVMI), target lesion/vessel revascularization (TLR/TVR) or stent thrombosis (ST). Post-procedural in-stent MLD (2.96 ± 0.34 versus 3.08 ± 0.33, P = 0.004) was smaller and diameter stenosis (11.7 ± 4.0% versus 9.0 ± 4.8%, P = 0.003) was higher in MSS group than COS group. At 1-year follow-up, in-stent MLD (2.76 ± 0.38 mm versus 2.65 ± 0.60 mm, P = 0.003) was reduced, LLL (0.20 ± 0.26 mm versus 0.42 ± 0.48 mm, P = 0.001), diameter stenosis (24.02 ± 20.94% versus 19.68 ± 11.75%, P = 0.028) and binary restenosis (18.7% versus 10.0%, P = 0.047) were increased in COS group. Angiographic success (96.7% versus 98.0%, P = 0.723) was similar between MSS group and COS group. At 1-year, the cumulative MACEs (12.0% versus 22.7%, P = 0.022) and TLR/TVR (10.0% versus 18.7%, P = 0.047) were reduced in MSS group as compared to COS group, there was no difference in cardiac death, TVMI and ST between the groups. Compared to conventional overlapped stenting, modified single stenting for TCALs is associated with similar angiographic success, fewer one-year cumulative MACEs and less treatment cost.
Key words:  Percutaneous coronary intervention      Tapered coronary artery lesion      Stenting     
Submitted:  27 February 2021      Revised:  03 May 2021      Accepted:  27 May 2021      Published:  24 September 2021     
Fund: 
81670332/National Natural Science Foundation of China
82020108015/National Natural Science Foundation of China
2019QH1078/Startup Fund for scientific research, Fujian Medical University
*Corresponding Author(s):  Lianglong Chen     E-mail:  lianglongchen@126.com
About author:  These authors contributed equally.

Cite this article: 

Dan Ke, Xi He, Chaogui Lin, Lianglong Chen. Comparison of standard versus modified stenting technique for treatment of tapered coronary artery lesions. Reviews in Cardiovascular Medicine, 2021, 22(3): 931-938.

URL: 

https://rcm.imrpress.com/EN/10.31083/j.rcm2203101     OR     https://rcm.imrpress.com/EN/Y2021/V22/I3/931

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