BACKGROUND:Before the "era" of optimal stent deployment, very few data concerning multiple stents in a single coronary artery showed restenosis rates up to 60%.OBJECTIVE:To evaluate the 6-month outcome of patients receiving multiple Palmaz-Schatz stents (> or =2 stents) in a single coronary artery compared to those receiving single stents.METHODS:Three hundred and forty-eight patients having multiple stents were compared to 174 patients receiving single stents during a 6-month follow-up.RESULTS:Repeat target lesion revascularization (RTLR), either repeat PTCA or CABG, was 10.4% in the single-stent group, 22.6% in the two-stent group, and 23.1% in the > or =2 stent group (p = 0.001, single versus 2 or > or =2 stents). There was not a significant difference between single stent and multiple stent groups in myocardial infarction and death during 6-month follow-up. Multivariate analysis showed multiple stents, diabetes mellitus, and type C lesion to be predictors of RTLR.CONCLUSIONS:Placement of two or more stents was associated with a significantly higher RTLR compared with single stent placement. The optimal approach to diffuse coronary artery disease remains to be defined.

Initial reports of percutaneous transluminal coronary angioplasty (PTCA) in the elderly (≥: 75 years) showed a significantly lower primary success rate, higher in‐hospital mortality, and a higher risk of emergency or elective coronary artery bypass graft (CABG) compared to younger patients. There are few data concerning acute outcomes and clinical follow‐up after the use of coronary stenting in the elderly compared to < the 75‐year‐old age group. We evaluated 82 elderly patients and 280 younger patients who received Palmaz‐Schatz stents during 1995, at a time when high pressure deployment and antiplatelet therapy was routinely used. The success rate and acute major complications were not significantly different between the elderly and younger patients. Clinical events (death, myocardial infarction [MI], repeat PTCA, or CABG) during 6‐month follow‐up were also not significantly different. Coronary stenting in the elderly can be carried out with a high success rate and low incidence of acute major complications. Thus, short‐term clinical outcomes in elderly patients appear similar to results obtained in younger patients.