Multiple overlapping Wiktor stenting for the treatment of diffuse lesions of small coronary arteries

: This study evaluated the usefulness of multiple overlapping stenting for the treatment of a diffuse lesion in a single and small coronary artery. We studied 48 consecutive patients with a lesion of a vessel with reference diameter or = 15.0 mm who were treated with 2 overlapping Wiktor stents; and Group S, 30 patients with a discrete lesion who were treated with a single Wiktor stent. Two patients with a discrete lesion were not included in Group S because of failure of stenting. Stenting was successful in all patients in Group D. One patient in Group S developed subacute thrombosis after stenting. Follow-up angiography was performed after 6 months. Before treatment, the lesion lengths in Groups D and S were 24.2 +/- 10.0 and 9.2 +/- 4.4 mm, the reference diameters were 2.56 +/- 0.32 and 2.69 +/- 0.33 mm, and the minimal lumen diameters were 0.42 +/- 0.34 and 0.53 +/- 0.40 mm, respectively, with no significant difference in the latter 2 parameters. Restenosis occurred in 72% and 30% (p = 0.01) and revascularization of the target lesion was successful in 67% and in 30% (p = 0.03), in Groups D and S, respectively, both significantly higher in Group D. Follow-up study revealed that the minimal lumen diameter and the net gain were significantly greater in the overlapping portion of the 2 stents than in the proximal and distal portions in Group D, with no significant difference in restenosis rate between these 3 portions. Multiple overlapping stenting using Wiktor stents is useful for diffuse lesions with unfavorable results after POBA even if the affected vessel is smaller than 3.0 mm. However, patients should be carefully observed because restenosis occurs frequently.