Angiographic follow-up after placement of a self-expanding coronary-artery stent

Details

Serval ID
serval:BIB_7BDF20C4536A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Angiographic follow-up after placement of a self-expanding coronary-artery stent
Journal
New England Journal of Medicine
Author(s)
Serruys  P. W., Strauss  B. H., Beatt  K. J., Bertrand  M. E., Puel  J., Rickards  A. F., Meier  B., Goy  J. J., Vogt  P., Kappenber  L., Sigwart  U.
ISSN
0028-4793 (Print)
Publication state
Published
Issued date
01/1991
Volume
324
Number
1
Pages
13-7
Notes
Clinical Trial Journal Article Research Support, Non-U.S. Gov't --- Old month value: Jan 3
Abstract
BACKGROUND. The placement of stents in coronary arteries after coronary angioplasty has been investigated as a way of treating abrupt coronary-artery occlusion related to the angioplasty and of reducing the late intimal hyperplasia responsible for gradual restenosis of the dilated lesion. METHODS. From March 1986 to January 1988, we implanted 117 self-expanding, stainless-steel endovascular stents (Wallstent) in the native coronary arteries (94 stents) or saphenous-vein bypass grafts (23 stents) of 105 patients. Angiograms were obtained immediately before and after placement of the stent and at follow-up at least one month later (unless symptoms required angiography sooner). The mortality after one year was 7.6 percent (8 patients). Follow-up angiograms (after a mean [+/- SD] of 5.7 +/- 4.4 months) were obtained in 95 patients with 105 stents and were analyzed quantitatively by a computer-assisted system of cardiovascular angiographic analysis. The 10 patients without follow-up angiograms included 4 who died. RESULTS. Complete occlusion occurred in 27 stents in 25 patients (24 percent); 21 occlusions were documented within the first 14 days after implantation. Overall, immediately after placement of the stent there was a significant increase in the minimal luminal diameter and a significant decrease in the percentage of the diameter with stenosis (changing from a mean [+/- SD] of 1.88 +/- 0.43 to 2.48 +/- 0.51 mm and from 37 +/- 12 to 21 +/- 10 percent, respectively; P less than 0.0001). Later, however, there was a significant decrease in the minimal luminal diameter and a significant increase in the stenosis of the segment with the stent (1.68 +/- 1.78 mm and 48 +/- 34 percent at follow-up). Significant restenosis, as indicated by a reduction of 0.72 mm in the minimal luminal diameter or by an increase in the percentage of stenosis to greater than or equal to 50 percent, occurred in 32 percent and 14 percent of patent stents, respectively. CONCLUSIONS. Early occlusion remains an important limitation of this coronary-artery stent. Even when the early effects are beneficial, there are frequently late occlusions or restenosis. The place of this form of treatment for coronary artery disease remains to be determined.
Keywords
Angiography Angioplasty, Transluminal, Percutaneous Coronary *Coronary Angiography Coronary Disease/mortality/*therapy Female Follow-Up Studies Humans Male Middle Aged Multicenter Studies Recurrence Stainless Steel *Stents
Pubmed
Web of science
Create date
15/02/2008 11:28
Last modification date
20/08/2019 14:37
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