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Background Recent studies have showed that the fine mesh stents are associated with a significant reduction in both clinical and angiographic re-stenosis of the coronary arteries.To maintain a very satisfactory radio-opacity using the stents,Guidant of the USA has designed a new type of bare metal stents (BMS)-Multi-link (ML) Vision/ML MiniVision stents.The clinical outcomes of Asian patients with coronary artery disease (CAD) after implanting the Multi-link Vision or MiniVision stent were investigated in this study. Methods An observational,prospective,multi-center,non-randomized post marketing registry was conducted to demonstrate the efficacy of the BMS- ML Vision/ML MiniVision stents.The primary end point of the registry was clinical target lesion revascularization (TLR) at a 6-month follow-up.The major secondary end points included the rate of major adverse cardiac events (MACE) and serious adverse events (SAE) in hospital and at 6 months;and the rate of clinical TLR as a function of the type of angina.A total of 429 Asian people with 449 lesions from 14 centers were selected for this study.The average reference diameter of the lesions was (3.0±0.5) mm,and the mean length was (15.7±5.0) mm. Results The successful rate of the procedure was 99.3%.Twenty-five percent of the lesions were treated by direct stenting without pre-dilation.Eighty-six percent of the lesions were implanted with ML Vision stent.After the 6-month follow-up,the rate of clinical TLR was 1.4%.The MACE,SAE and target vessel revascularization (TVR) were 6.8%,3.5% and 1.4% respectively. Conclusion The current registry showed the excellent 6-month clinical outcomes of ML Vision/ML MiniVision stents in Asian patients with CAD. Chin Med J 2007;120(12):1093-1096

Several studies have shown that coronary stenting reduces the frequency of clinical and angiographic restenosis in patients with mild to moderate renal insufficiency. However, less is known about the long-term benefits of stent use in this population. This study was aimed to determine the impact of coronary stenting on extended (5 years) long-term outcomes of patients with chronic renal insufficiency.The study included 602 consecutive patients who underwent successful percutaneous coronary intervention with stenting. Renal insufficiency was defined as an estimated glomerular filtration rate60 ml x min(-1) x 1.73 m(-2). The major adverse cardiac events were compared for patients with (n = 160) and without (n = 442) renal insufficiency.After the third year of follow-up, nonfatal myocardial infarction and revascularization rates were significantly increased in patients with renal insufficiency compared with those without renal dysfunction (16.9% vs 7.7%, P = 0.001; 29.4% vs 15.8%, P0.001). In patients who had recurrent cardiovascular events, a significantly higher rate of de novo stenosis revascularization was found in patients with renal insufficiency than without renal insufficiency (57.7% vs 22.7%, P0.001), while there was no significant difference in target lesion revascularization between the groups (51.9% vs 43.6%, P = 0.323). Multivariate analysis demonstrated an independent impact of the presence of renal insufficiency on the major adverse cardiac events (hazard ratio: 1.488, 95% confidence interval: 1.051 - 2.106, P = 0.025) and de novo stenosis (hazard ratio: 5.505, 95% confidence interval: 2.151 - 14.090, P0.001).The late major adverse cardiac events, after successful coronary stenting, is increased in patients with an estimated glomerular filtration rate60 ml x min(-1) x 1.73 m(-2). This might be associated with increased risk of de novo stenosis in this population.