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Objective To evaluate acute and long2term angiographic and clinical outcomes of longstent or multiple overlapped stents (length ≥ 20 mm) implantation for diffuse atherosclerosis lesions Methods Long stent or multiple overlapped stents implantation was performed on 111diffuse native coronary lesions ( Group O : 47 lesions in 44 octogenarians ; Group Y: 64 lesions in 58 patientsaged under 60) Baseline demographic , lesion characteristic , angiographic and procedural details weresimilar in these 2 Six2month clinical and angiographic follow2up was completed in all In2hospital and long2term outcomes were Results Procedure success was 100 %for both None had in2hospital major adverse cardiac events (MACE) There was no significant difference inangiographic binary restenosis ( ≥50 % diameter stenosis) rate between the groups at follow2up ( Group O Group Y, 1218 % vs1 1019 % at 32month , 2918 % 2616 % at 62month , P > 0105) The rates oftarget lesion revascularization and MACE at follow2up were less in Group Y, but it showed no statisticalsignificance (718 % 1016 % and 816 % 1114 % at 32month , 1516 % 2314 % and 2017 % 2510 % at 62month , respectively , P > 0105) Conclusions Long stent implantation for diffuse lesionsin octogenarians appears safe and feasible , with high procedural success and favorable long2term