Circulation, Vol 83, 148-161, Copyright © 1991 by American Heart Association
RA Schatz, DS Baim, M Leon, SG Ellis, S Goldberg, JW Hirshfeld, MW Cleman, HS Cabin, C Walker and J Stagg
Stenting of native coronary arteries with a balloon-expandable stent was
attempted in 226 patients after elective angioplasty. Delivery of the
device was successful in 213 (94%) of the patients. Of these, 39 received
aspirin and dipyridamole only (group 1) and 174 received aspirin,
dipyridamole, and warfarin for 1-3 months (group 2). There was no abrupt
closure (less than or equal to 1 day) or perioperative death in either
group. In-hospital or perioperative complications in group 1 compared with
group 2 were as follows: subacute closure (1-14 days), seven (18%) patients
versus one (0.6%) patient, respectively, p less than 0.0001; myocardial
infarction, five (13%) patients versus one (0.6%) patient, respectively;
condition requiring urgent bypass surgery, one (2.5%) patient versus no
patients, respectively. Thus, the incidence of major complications such as
death, myocardial infarction, or a condition requiring urgent bypass
surgery was 15% in group 1 and 0.6% in group 2. Clinical follow-up revealed
that 92% of the patients were asymptomatic at 3 months after stenting
compared with 6% before stenting (p less than 0.0001). Of the 13 patients
who were symptomatic, nine underwent cardiac catheterization and,
ultimately, successful elective coronary angioplasty or bypass surgery. We
conclude that a high delivery success rate can be expected with this device
and that clinical thrombosis is less frequent in anticoagulated patients
than in nonanticoagulated patients. Furthermore, in this selected patient
population, coronary stenting results in a low incidence of in-hospital and
perioperative complications. Clinical success, defined by absence of
symptoms, appears to be sustained at 3 months.
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Clinical experience with the Palmaz-Schatz coronary stent. Initial results of a multicenter study
Cardiology Division, Arizona Heart Institute Foundation, Phoenix.
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