Overlapping of coronary stents

Q: In long coronary artery lesion, overlapping of drug-eluting stents (DES) decreases the rate of re-stenosis? (select one)

A) True
B) False


Answer: False

Unfortunately and defying the logic, the use of multiple overlapping DES, which may be required for longer lesions in coronary vessel are associated with more chances of re-stenosis. Different explanations have been proposed including drug toxicity, polymer instability in the overlapping segments, persistent inflammation or delayed reendothelialization at the overlapping sites. But still, it may be the treatment of choice in such situations, given risk vs benefit.

#cardiology
#procedures


References:

1. Kereiakes DJ, Wang H, Popma JJ, et al. Periprocedural and late consequences of overlapping Cypher sirolimus-eluting stents: pooled analysis of five clinical trials. J Am Coll Cardiol 2006; 48:21.

2. Finn AV, Kolodgie FD, Harnek J, et al. Differential response of delayed healing and persistent inflammation at sites of overlapping sirolimus- or paclitaxel-eluting stents. Circulation 2005; 112:270.