• Young-Hak Kim, Seong-Wook Park, Cheol Whan Lee, Myeong-Ki Hong, Hyeon-Cheol Gwon, Yangsoo Jang, Myoung Mook Lee, Bon Kwon Koo, Dong Joo Oh, Ki Bae Seung, Seung-Jae Tahk, Junghan Yoon, and Seung-Jung Park.
• Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
• Catheter Cardiovasc Interv. 2006 Feb 1; 67 (2): 181-7.

ObjectiveThis study compared the efficacy of the sirolimus-eluting stent (SES), the paclitaxel-eluting stent (PES), and the bare metal stent (BMS) for long coronary lesions.BackgroundThe outcome of drug-eluting stent (DES) implantation in long coronary lesions remains unclear.MethodsThe study involved 527 patients with de novo long coronary lesions (> or = 24 mm), which were treated with long (> or = 28 mm) SESs (223 lesions), PESs (194 lesions), or BMSs (201 lesions).ResultsLesions in the SES (36.0 +/- 14.9 mm, P < 0.001) and PES (36.3 +/- 14.5 mm, P < 0.001) groups were longer than those in the BMS group (32.0 +/- 12.3 mm), meaning the two DES groups had longer stented segments than did the BMS group. Six-month angiographic follow-up showed the SES (9.3%, P < 0.001) and PES (21.3%, P < 0.001) groups had lower in-segment restenosis rates than that of the BMS group (42.5%). The rate of major adverse cardiac events (MACE) including death, myocardial infarction, and target lesion revascularization at 9 months was higher in the BMS group (26.6%) than that in the SES (13.0%, P < 0.001) and PES (15.7%, P < 0.001) groups. Posthoc analysis of the two DES groups showed that the in-segment restenosis rate was lower for the SES than that for the PES group (P = 0.002), while the MACE rate was similar.ConclusionsThe use of DESs for long coronary lesions appears to be safe and more effective than the use of BMSs in terms of restenosis and adverse clinical events. SES use was associated with lower late luminal loss and a lower angiographic restenosis rate compared with PES use.2006 Wiley-Liss, Inc.

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