(Circulation. 1995;91:1397-1402.)
© 1995 American Heart Association, Inc.
Articles |
Coronary Stenting Decreases Restenosis in Lesions With Early Loss in Luminal Diameter 24 Hours After Successful PTCA
From the Cardiac Unit, Anchorena Hospital, Buenos Aires, Argentina (A.E.R., O.S., M.L., M.F., R.S., N.P.B.); the Cardiac Unit, Massachusetts General Hospital, Harvard Medical School, Boston (J.B.N., I.F.P.); and the Cardiac Unit, University of Alabama, Birmingham (G.S.R.).
Correspondence to Igor F. Palacios, MD, Director of Interventional Cardiology, Cardiac Unit, Massachusetts General Hospital, Boston, MA 02114.
Background Early loss of minimal luminal diameter (MLD) after successful percutaneous transluminal coronary angioplasty (PTCA) is associated with a higher incidence of late restenosis.
Methods and Results Sixty-six patients (66 lesions) with >0.3
mm
MLD loss at 24-hour on-line quantitative coronary angiography were
randomized into two groups: 1, Gianturco-Roubin stent (n=33) and 2,
Control, who received medical therapy only (n=33). All lesions were
suitable for stenting. Baseline demographic, clinical, and angiographic
characteristics were similar in the two groups. Restenosis (
50%
stenosis) for the overall group occurred in 32 of 66 patients (48.4%)
at 3.6±1-month follow-up angiography. Restenosis was significantly
greater in group 2 than in group 1 (75.7% versus 21.2%,
P<.001). Vascular complications (21.2% versus 0%) and
length of hospital stay (7.3±1 versus 2.4±0.5 days,
P<.01) were higher for the stent group. Although at
follow-up there were no differences in mortality or incidence of acute
myocardial infarction between the two groups, patients in the control
group had a higher incidence of repeat revascularization procedures
(73% versus 21%, P<.001).
Conclusions In patients with successful PTCA but reduced luminal diameter demonstrated by repeat angiography at 24 hours, the Gianturco-Roubin stent appears to reduce angiographic restenosis at follow-up.
Key Words: stents • stenosis • angioplasty
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