Shortening the stent length reduces restenosis with bare metal stents: Matched pair comparison of short stenting and conventional stenting

Abstract

Objective: To investigate the effect of reducing stent length on the rate of target lesion restenosis. Design: In a prospective investigation, acute and long term results of a short stenting procedure were analysed by quantitative angiography and compared with results of a conventional stenting procedure selected according to a matched pairs analysis. Patients: Short stents were implanted in 400 consecutive patients with 404 lesions and conventional stents in 430 patients. Demographic and lesion characteristics were comparable between groups. Interventions: In short stenting, the shortest stent length to cover only segments with > 30% reduction in vessel diameter was used. In conventional stenting, full coverage of a stenotic vessel segment was intended. Main outcome measures: The mean stent lengths of the short stent group (9.8 (4) mm) and the conventional stent group (16.3 (7) mm) differed significantly (p < 0.0001); all other procedural and angiographic parameters were the same. Procedural success was similar for both groups. Control angiography after six months was conducted in 92% of patients. Results: Short stenting resulted in both less restenosis (68 of 431 (15.8%)) than conventional stenting (93 of 381 (24.4%), p = 0.007) and less late lumen loss (0.6(0.6) mm v0.75 (0.5) mm, p = 0.0001). Residual stenosis (< 45%) in adjacent vessel segments after short stenting did not affect the restenosis rate. Only the implantation of a ≤ 9 mm stent predicted the absence of restenosis in a multivariate analysis. Conclusion: Shortening the length of bare metal stents reduces the restenosis rate as compared with conventional stenting.