Stenting of a patient with long coronary artery lesion under the control of optical coherence tomography (clinical case)
https://doi.org/10.29001/2073-8552-2023-38-2-286-292
Abstract
One of the topical issues in percutaneous coronary interventions (PCI) is the stenting of extended lesions. Currently, there are two main approaches: stenting with a single long stent (SLS) and stenting with two or more overlapping stents (OS). However, due to the conical geometry of the vessel, stenting of the SLS with a large difference between the proximal and distal reference diameters of the artery may lead to worse results than stenting of the OS, due to lower device compliance to the vessel. The article presents a clinical case illustrating our proposed algorithm for making a decision in favor of SLS or OS based on data obtained using optical coherence tomography.
About the Authors
I. V. Suslov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
Ivan V. Suslov - Junior Research Scientist, Laboratory of RoentgenEndovascular Surgery
111a, Kievskaya str., Tomsk, 634012, Russian Federation
S. E. Pekarskiy
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
Stanislav E. Pekarskiy - Dr. Sci. (Med.), Leading Research Scientist, Laboratory of Roentgen-Endovascular Surgery
111a, Kievskaya str., Tomsk, 634012, Russian Federation
M. G. Tarasov
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
Mikhail G. Tarasov - Cand. Sci. (Med.), Junior Research Scientist, Laboratory of Roentgen-endovascular surgery
111a, Kievskaya str., Tomsk, 634012, Russian Federation
A. E. Baev
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
Andrey E. Baev - Cand. Sci. (Med.), Head of the Laboratory of Roentgen-Endovascular Surgery
111a, Kievskaya str., Tomsk, 634012, Russian Federation
S. I. Vintizenko
Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences
Russian Federation
Russian Federation
Stanislav I. Vintizenko - Cand. Sci. (Med.), Endovascular Surgeon, Department of Invasive Cardiology
111a, Kievskaya str., Tomsk, 634012, Russian Federation
References
1. Tommaso C.L. Long stents as a risk factor for late stent thrombosis size does matter. JACC Cardiovasc. Interv. 2010;3(4):390–391. DOI: 10.1016/j.jcin.2010.01.014.
2. Suh J., Park D.W., Lee J.Y., Jung I.H., Lee S.W., Kim Y.H. et al. The relationship and threshold of stent length with regard to risk of stent thrombosis after drug-eluting stent implantation. JACC Cardiovasc. Interv. 2010;3(4):383–389. DOI: 10.1016/j.jcin.2009.10.033.
3. Sim H.W., Thong E.H., Loh P.H., Lee C.H., Chan M.Y., Low A.F. et al. Treating very long coronary artery lesions in the contemporary drugeluting-stent era: Single long 48 mm stent versus two overlapping stents showed comparable clinical outcomes. Cardiovasc. Revasc Med. 2020;21(9):1115–1118. DOI: 10.1016/j.carrev.2020.02.005.
4. Balachandran A., Gopinath K.S., Gupta N.P., Koshy A.G., Viswanathan S. Clinical Profile and outcomes of overlapping v/s single long stent in long coronary lesions – The Trivandrum Long Stent (TRILO) Study. Indian Heart Journal. 2014;66(S2):S102–S103. DOI: 10.1016/j.ihj.2014.10.285.
5. Souteyrand G., Amabile N., Mangin L., Chabin X., Meneveau N., PESTO Investigators et al. Mechanisms of stent thrombosis analysed by optical coherence tomography: insights from the national PESTO French registry. Eur. Heart J. 2016;37(15):1208–1216. DOI: 10.1093/eurheartj/ehv711.
6. Adriaenssens T., Joner M., Godschalk T., Malik N., Alfonso F., Xhepa E. et al. Prevention of late stent thrombosis by an interdisciplinary Global European Effort (PRESTIGE) Investigators. Optical coherence tomography findings in patients with coronary stent thrombosis: a report of the PREvention of Late Stent Thrombosis by an Interdisciplinary Global European Effort (PRESTIGE) Consortium. Circulation. 2017;136(11):1007–1021. DOI:10.1161/CIRCULATIONAHA.117.026788.
Review
For citations:
Suslov I.V., Pekarskiy S.E., Tarasov M.G., Baev A.E., Vintizenko S.I. Stenting of a patient with long coronary artery lesion under the control of optical coherence tomography (clinical case). Siberian Journal of Clinical and Experimental Medicine. 2023;38(2):286-292. (In Russ.) https://doi.org/10.29001/2073-8552-2023-38-2-286-292
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