Acute angiographic and clinical results of long balloon percutaneous transluminal coronary angioplasty and adjuvant stenting for long narrowings

Acute directional coronary atherectomy prior to stenting in complex coronary lesions: ADAPTS study

“…Arguably, DCA is technically more demanding than stenting and, if performed extensively, may result in perforation, adventitial hematoma, dissection, or distal embolization [11,[48][49][50]. The available data on stenting of aorto-ostial lesions, long (Ͼ15-mm) stenoses, total chronic occlusions, saphenous vein grafts (SVGs), and lesions containing thrombus indicate an associated restenosis rate of 30-60%, as well as higher complication rates [17,18,22,[51][52][53]. High elastic recoil may contribute to increased restenosis rates, particularly in total chronic occlusions and aorto-ostial lesions [31,[35][36][37].…”

Preliminary experience with stent-supported coronary angioplasty in long narrowings using the long freedom force stent: Acute and six-month clinical and angiographic results in a series of 27 consecutive patients

“…We chose to test this new device using a more specific approach, i.e., by selecting consecutive patients with long narrowings and using long stents. Patients with long and diffuse lesions have been considered unfavorable candidates for percutaneous intervention because of a lower success rate and a higher complication and restenosis rate [1][2][3][4][5][6][7]. Selection based on the presence of unfavorable lesions may be potentially useful for a preliminary evaluation of this new device in a small sample of patients.…”

“…Lesion length Ͼ20 mm has long been regarded as a predictor of reduced procedural success, and of a higher incidence of complications and restenosis [1][2][3][4][5][6][7]. More advanced equipment design, coupled with availability of adjunct procedures such as rotational atherectomy, laser angioplasty, and stenting, has dramatically improved the acute results of percutaneous revascularization procedures for long narrowings, but the restenosis rate remains high despite an optimal acute angiographic result.…”

Placement of multiple and different stent types for very long dissections during coronary angioplasty

“…Cannon and coworkers obtained angiographic success in 85% of their 82 patients with conventional PTCA. Adjuvant single Gianturco-Roubin stent placement was required in the others because of bailout reasons [15]. More recently, Keane and colleagues described the usefulness of the Micro stent as a single device or complementary to other stents placed for complex dissections [16].…”