Aims To prospectively evaluate the influence of stent length on 6 month clinical and angiographic outcome, in patients with native coronary lesions up to 45mm in length, undergoing elective Magic Wallstent implantation. Methods and Results On the basis of pre-procedural angiography, 276 patients (aged 61·3±10·2 years; 78·6% male; 41·7% unstable angina) with a total of 302 lesions were prospectively assigned to one of five different length categories of Magic Wallstent. Angiography in multiple matched projections before and after implantation and at 6 months follow-up was analysed at the core laboratory. Primary end-points for the efficacy analysis were cumulative incidence of major adverse cardiac events and quantitative coronary angiography analysis 6 months after stent implantation. Magic Wallstent implantation was successful in 301 of 302 lesions and in 98·6% a residual stenosis <20% by online quantitative coronary angiography was achieved. At 30 days, 6·2% (1·8% subacute occlusion) of patients had experienced major adverse cardiac events, 27·5% at 6 months and 30·4% at 9 months. Angiographic restenosis occurred in 37%. Restenosis rates for the mini, extra-short, short, medium and long Wallstent groups were 25·9%, 25%, 22·6%, 36·2% and 67·5%, respectively. Multivariate analysis revealed stent length to be independently associated with greater angiographic restenosis and major adverse cardiac events. Conclusions While shorter Magic Wallstents provided late outcomes comparable with short balloon-expandable stents, excessive restenosis with longer Wallstents should obviate their use in elective percutaneous intervention. Long coronary lesions provide a challenging substrate for emerging antirestenosis therapies, such as stent coatings and brachytherapy.

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European Heart Journal
Erasmus MC: University Medical Center Rotterdam

Foley, D.P, Pieper, M, Wijns, W, Suryapranata, H, Grollier, G, Legrand, V.M.G, … Serruys, P.W.J.C. (2001). The influence of stent length on clinical and angiographic outcome in patients undergoing elective stenting for native coronary artery lesions; final results of the Magic 5L Study. European Heart Journal, 22(17), 1585–1593. doi:10.1053/euhj.2001.2752