Volume 10, Number 1, January-February 2003

‘Real world’ small vessel coronary artery stenting: an analysis
Allison Morton, Thomas Papadopoulos, Clare Wales, Robert Bowes, Stephen Campbell, David Oakley, Nigel Wheeldon, Christopher Newman, David Crossman, David Cumberland, Julian Gunn

The objective of this study was to describe the context, procedural outcome and long-term results of contemporary small vessel (SV) coronary artery stenting. It was set in a tertiary cardiology centre. The study was designed as a retrospective analysis of the procedural and long-term results in a consecutive series of patients undergoing implantation of an SV stent (defined as < 2.5 mm) in 1999–2000.
Of the 1,130 percutaneous coronary interventions (PCIs) in the study period, 138 (12%) involved placement of SV stents. Of these interventions 58% consisted of SV stents as sole treatment. Some 69% of patients were male and their mean age was 58 years; 46% were hypertensive, 13% diabetic, 84% hypercholesterolaemic and 18% were smokers. Of these patients 54% were in anginal classes III and IV. Of the SV stents fitted, 94% were 2.5 mm and 6% were 2.0 mm. 75% of SV stents were implanted in main epicardial vessels. The mean follow-up for these patients was 17 months. Long-term symptomatic benefit was achieved in 76%. The major adverse cardiac events (MACE) rate was 15%, comprising 1% acute myocardial infarction (AMI) and 14% re-PCI. There were no deaths.
In conclusion, SV stenting in the modern era, in an unselected series of patients, is performed in 12% of PCI procedures. It comprises the sole treatment in 58% of these interventions. The majority of SV stents are 2.5 mm and are placed in main coronary arteries. Procedural and long-term results are excellent. These data may inform the choice of treatment for patients with SV disease and may be useful in planning studies in stenting SVs.

Br J Cardiol 2003;10:AIC28-AIC32.

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