Comparison of long-term outcomes between a single versus a multiple stent brand strategy during [i]“full metal jacket”[/i] procedures

Abstract

To the Editor, Treatment failure is a major concern after full metal jacket (FMJ) stenting procedures, defined as overlapping stent length ≥ 60 mm. These procedures are often required to treat tandem or extensive coronary lesions.1 Several brands of stents are currently approved, each displaying different characteristics and performance. However, real-world practice is not restricted to the use of a brand exclusive strategy and may involve a combination of different brands. Limited data exist on the relative safety and efficacy of these different strategies during percutaneous coronary intervention (PCI). Therefore, our aim was to compare clinical outcomes after the use of a single stent brand vs multiple stent brands following successful FMJ PCI. From a dedicated database of 23 021 consecutive PCI procedures performed between January 2002 and December 2018 at a high-volume coronary intervention laboratory, we retrospectively identified 592 patients (3%) who underwent FMJ procedures. Written informed consent was obtained from all patients. Stent selection was left to the operator’s discretion. We excluded patients with unsuccessful procedures and those lost to follow-up from the analysis. Demographic, clinical, angiographic, and procedural variables were evaluated. The primary endpoint consisted of major adverse cardiac events (MACE), which included all-cause death, myocardial infarction (MI), and...