Real-World Experience with a 60-mm-Long Stent in the Setting of Primary Percutaneous Coronary Intervention

INTRODUCTION: Primary percutaneous coronary intervention (PPCI) represents a timely procedure that requires speedy revascularization. Moreover, PPCI in diffuse coronary lesions remains to be challenging even in the hands of experienced operators as the use of a long stent may increase the difficulty of the procedure in terms of stent delivery, deployment, and optimization. However, the practicability and clinical outcomes of deployment of a 60-mm-long stent in the setting of PPCI remain to be determined. METHODS: The study is a retrospective observational analysis in a prospective cohort. The prospectively gathered data of consecutive patients from June 2016 to December 2019, who underwent PPCI with BioMime sirolimus-eluting stents 2.5–3.0/60 mm or 3.0–3.5/60 mm were analyzed at 1 year regarding the primary outcome of major adverse cardiovascular and cerebrovascular events (MACCE) and target lesion revascularization (TLR). RESULTS: A total of 88 cases were included in the study; 23 cases underwent PPCI, whereas 65 underwent nonPPCI. The PPCI group had a mean age of 65.7 ± 10.9 years compared with 63.3 ± 9.6 years (P = 0.34) in the nonPPCI group. Eighty-three percentage of PPCI were males compared with 94% of their nonPPCI counterparts (P = 0.20). In addition, the prevalence of hypertension was more common in the PPCI group (87% vs. 63%, P = 0.03). There was no statistically significant difference between the two groups regarding other comorbidities. The most common culprit vessel was the left anterior descending artery (57%) in the PPCI group and the right coronary artery (58%) in the nonPPCI. The use of a stent with a diameter of 2.5–3.0 mm was more common in both groups (61% in PPCI vs. 66% in nonPPCI, P = 0.8). MACCE occurred in four patients during a year of follow-up. One occurred in the PPCI group (4%) compared with three in the nonPPCI group (5%) (P = 1.00). TLR was required in two cases, one in each group (4% vs. 2%, P = 0.46). CONCLUSION: The use of a 60-mm-long stent in the setting of PPCI has an excellent 12-month outcome in procedural success, MACCE, and TLR. Large randomized studies are required to confirm these results.