Worse six-month outcome for patients with multiple stents in a single coronary artery

Background. Before the "era" of optimal stent deployment, very few data concerning multiple stents in a single coronary artery showed restenosis rates up to 60%. Objective. To evaluate the 6-month outcome of patients receiving multiple Palmaz-Schatz stents (greater than or equal to 2 stents) in a single coronary artery compared to those receiving single stents. Methods. Three hundred and forty-eight patients having multiple stents were compared to 174 patients receiving single stents during a 6-month follow-up. Results. Repeat target lesion revascularization (RTLR), either repeat PTCA or CABG, was 10.4% in the single-stent group, 22.6% in the two-stent group, and 23.1% in the greater than or equal to 2 stent group (p = 0.001, single versus 2 or greater than or equal to 2 stents). There was not a significant difference between single stent and multiple stent groups in myocardial infarction and death during 6-month follow-up. Multivariate analysis showed multiple stents, diabetes mellitus, and type C lesion to be predictors of RTLR. Conclusions. Placement of two or more stents was associated with a significantly higher RTLR compared with single stent placement. The optimal approach to diffuse coronary artery disease remains to be defined.