Acute and long-term outcomes of stenting in coronary vessel > 3.0 mm, 3.0-2.5 mm, and < 2.5 mm

We compared the acute and long‐term outcomes of stentings in coronary vessels > 3.0 mm, 3.0–2.5 mm, and < 2.5 mm. A total of 1,152 patients underwent coronary stenting was divided into three groups based on the reference vessel size. Group A consisted of 598 patients (667 lesions) with a reference vessel diameter > 3.0 mm, group B 485 patients (544 lesions) with a reference vessel diameter of 3.0–2.5 mm, and group C 114 patients (119 lesions) with a reference vessel diameter < 2.5 mm. The procedural success, stent thrombosis, and in‐hospital cardiac event rate were similar in the three groups. At 6‐month angiographic follow‐up, the lesion restenotic rate was significantly higher in the small‐vessel group (14%, 22%, and 26% in groups A, B, and C, respectively; P = 0.011). These differences appeared to result from a lesser acute gain and a lesser net gain in small‐vessel group; the late luminal loss was similar in the three groups. During a follow‐up duration of 28 ± 3 months, group C patients had a significantly lower rate of event‐free survival than the group A and B patients (71% vs. 85% and 82%; P = 0.002). Stepwise regression analysis demonstrated that complex lesion (P = 0.032) and long lesion (P = 0.046) are independent predictors of restenosis in very‐small‐vessel (< 2.5 mm) stenting. In conclusion, the acute results of stenting in small coronary arteries appear safe and feasible with a high procedural success rate and a low incidence of stent thrombosis. Stenting in patients with a small coronary artery appears to have a similar in‐hospital cardiac event rate, but a higher angiographic restenosis rate and a lower event‐free survival rate, compared to stenting in patients with a larger coronary artery. The predictors of restenosis in very‐small‐vessel stenting are complex lesions and long lesions. Cathet Cardiovasc Intervent 2001;53:314–322. © Wiley‐Liss, Inc.