Key result
Small-vessel stenting yields no 12-month major events but shows a ~41% 5-month restenosis rate.
Observational (n=44)
Answers are grounded in this paper and cite their sources.
BACKGROUND AND HYPOTHESIS: Increased operator experience, greater insight in stent deployment techniques, and improved poststent medication regimen have significantly reduced the risk of thrombotic stent closure following stent placement in large coronary arteries (> or = 3.0 mm in diameter). Whether equally favorable results are afforded by stent placement in small vessels (< 3.0 mm), however, remains unclear. Accordingly, the aim of this study was the specific examination of the risk of stent placement in small native coronary vessels, using stent deployment technique consisting of supplementary dilatations with larger balloons or high-pressure inflations, and aggressive aspirin-ticlopidine and short-term oral anticoagulation poststent therapy. METHODS: Forty-seven balloon-expandable stents (20 Gianturco-Roubin, 21 NIR, 6 Palmaz-Schatz) were successfully implanted without intravascular guidance in 45 native coronary arteries (mean reference diameter of 2.5 mm) in 44 consecutive patients (31 men, 13 men), the majority of whom (87%) were stented for the treatment of failed or suboptimal balloon angioplasty outcome. RESULTS: Successful stent placement reduced the lesion diameter stenosis from 91 +/- 9% to 3 +/- 7% (p = 0.0001). There were no early stent thrombosis or major cardiovascular events prior to hospital discharge. During a 12-month follow-up period, most patients remained symptomatically improved and no myocardial infarction, stroke, or death was observed. Five-month angiographic reassessment revealed an in-stent restenosis rate of 41%, which was higher in vessels < or = 2.5 mm in size (47 vs. 33% for vessels > 2.5 mm, p = 0.2747). CONCLUSIONS: In selected patients with small native coronary vessels < 3.0 mm in diameter, angiography-guided optimal stent placement is associated with a low risk of stent thrombosis and bleeding complications. However, the in-stent restenosis rate is high with the stents used in this study.
No takes yet. Share an insight, caveat, or question.
Lau et al. (1997) conducted an observational in Small native coronary artery lesions (< 3.0 mm in diameter) (n=44). Angiography-guided balloon-expandable stent placement with aggressive aspirin-ticlopidine and short-term oral anticoagulation was evaluated on In-stent restenosis at 5-month angiographic reassessment and 12-month major cardiovascular events (stent thrombosis, MI, stroke, or death). Angiography-guided stenting in small coronary arteries had 0% early stent thrombosis or 12-month major events, but a 41% 5-month in-stent restenosis rate.
Synapse has enriched 10 related papers. Consider them for comparative context: