ABSTRACT
Implantation of bare metal stents over a long vessel segment has long been considered to be an important risk factor for restenosis and poorer clinical outcomes.137-143 Therefore, stent placement for diffusely diseased coronary segments is commonly avoided and is a frequent cause for deferring the percutaneous treatment. To date, randomized trials with sirolimus-eluting stents (SES) have only enrolled patients with relatively short lesion lengths. The RAVEL trial included only single lesions covered by an 18-mm long SES.18 In the SIRIUS trial,19 relatively longer stent placement was allowed (maximum of 2 overlapping 18-mm long SES). Similarly, the E-SIRIUS and C-SIRIUS trials20,21 only included lesions 15-32 mm by visual assessment that could be completely covered by a maximum of two 18-mm SES. Therefore, the safety and efficacy of SES implanted over a total coronary length >36 mm has not been tested to date and is evaluated in the present chapter.
