Comparison of Outcomes Between Single Long Stent and Overlapping Stents: a Meta-Analysis of the Literature

Abstract

ObjectivesThere is no consensus on whether to treat diffuse coronary artery lesions with a single long stent (SLS) or by overlapping two or more stents (OLS). The goal of this review was to compare the outcomes of these two approaches through a meta-analysis of the literature.MethodsWe searched for relevant studies in MEDLINE, Scopus, EMBASE, Google Scholar, and the Cochrane Library. Our meta-analysis included 12 studies (n = 6414) that reported outcomes during the follow-up period.ResultsIndividuals who received OLS had a greater risk of cardiac mortality and target lesion revascularization (TLR) than those who received SLS (RR: 1.51, CI: 1.03-2.21, p = 0.03, I-2 = 0% and RR: 1.64, CI: 1.02-2.65, p = 0.04, I-2 = 38%, respectively). The fluoroscopy period in the OLS group was longer than in the SLS group (SMD: 0.35, CI: 0.25-0.46, p < 0.01, I-2 = 0%). more contrast volume was sued for the OLS group; however, there was substantial variability in the pooled analysis (I-2 = 95%). In terms of all outcomes, there were no differences between stent generation types.ConclusionIn the first meta-analysis of mainly observational data comparing OLS vs. SLS for long coronary lesions, OLS had higher rates of cardiac mortality and TLR as well as longer fluoroscopy times compared to SLS.