Itoh A, Hall P, Maiello L, Di Mario C, Moussa I, Blengino S, Ferraro M, Martini G, Di Francesco L, Finci L, Colombo A
Centro Cuore Columbus, Milan, Italy.
Mayo Clin Proc. 1997 Feb;72(2):101-11. doi: 10.4065/72.2.101.
To analyze the results of implantation of six different intracoronary stents without the use of prolonged anticoagulation.
Between Mar. 30, 1993, and Jun. 30, 1995, 889 patients with 1,194 coronary or vein graft lesions underwent implantation of one of six types of stents-Palmaz-Schatz, Gianturco-Roubin, Wiktor, Micro, Cordis, or Wallstent. The patients were classified into seven groups on the basis of the type of stent that was implanted, including one group with combined use of two or more types of stents. Among the 851 patients with successful stent delivery and without major complications, 801 received only antiplatelet therapy, and 50 received a standard anticoagulation regimen. One-month clinical followup data were obtained in all patients, and clinical events were investigated.
The mean number of stents was 1.8 per lesion and 2.4 per patient. Procedural success was achieved in 93% of the lesions. The clinical success rate at 1 month was 90%. Intravascular ultrasound assessment was performed in 90% of the lesions. The final minimal luminal cross-sectional area of the stent increased from 6.8 to 7.8 mm2 after intravascular ultrasound-guided optimization. Within 1 month, 16 stent thrombosis events (1.9%) occurred. No significant differences were noted in stent thrombosis rates among the various stent cohorts. Multivariate logistic regression analysis revealed that the final stent minimal luminal diameter measured by intravascular ultrasonography was the only variable associated with stent thrombosis.
This study showed that six different stents could possibly be inserted without subsequent anticoagulation if optimal stent expansion and total lesion coverage were achieved.
