Shortening the stent length reduces restenosis with bare metal stents: matched pair comparison of short stenting and conventional stenting.

OBJECTIVE To investigate the effect of reducing stent length on the rate of target lesion restenosis. DESIGN In a prospective investigation, acute and long term results of a short stenting procedure were analysed by quantitative angiography and compared with results of a conventional stenting procedure selected according to a matched pairs analysis. PATIENTS Short stents were implanted in 400 consecutive patients with 464 lesions and conventional stents in 430 patients. Demographic and lesion characteristics were comparable between groups. INTERVENTIONS In short stenting, the shortest stent length to cover only segments with > 30% reduction in vessel diameter was used. In conventional stenting, full coverage of a stenotic vessel segment was intended. MAIN OUTCOME MEASURES The mean stent lengths of the short stent group (9.8 (4) mm) and the conventional stent group (16.3 (7) mm) differed significantly (p < 0.0001); all other procedural and angiographic parameters were the same. Procedural success was similar for both groups. Control angiography after six months was conducted in 92% of patients. RESULTS Short stenting resulted in both less restenosis (68 of 431 (15.8%)) than conventional stenting (93 of 381 (24.4%), p = 0.007) and less late lumen loss (0.6 (0.6) mm v 0.75 (0.5) mm, p = 0.0001). Residual stenosis (< 45%) in adjacent vessel segments after short stenting did not affect the restenosis rate. Only the implantation of a < or = 9 mm stent predicted the absence of restenosis in a multivariate analysis. CONCLUSION Shortening the length of bare metal stents reduces the restenosis rate as compared with conventional stenting.