Serial angiographic follow-up after palmaz-schatz stent implantation: Comparison with conventional balloon angioplasty

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Abstract

Objectives. Serial angiographic follow-up study was designed to evaluate the temporal mode of lumen diameter changes after Palmaz-Schatz stent implantation, and the results were compared with those from a cohort of patients undergoing balloon angioplasty. Background. Restenosis remains a major limitation of balloon angioplasty. The Palmaz-Schatz balloon expandable coronary stent is now under clinical investigation to evaluate its efficacy in preventing restenosis. Methods. Serial angiographic follow-up study was performed the day after stent implantation and at 1, 3 and 6 months after the procedure. The stent group consisted of 96 patients who had 97 lesions with a single stent. A cohort of 179 patients with 192 lesions were selected as the balloon group by the criteria of final balloon size ≥3 mm and lesion length <20 mm. Results. A significantly larger lumen diameter was obtained immediately after stent implantation (2.9 ± 0.4 mm [mean ± SD] in the stent group vs. 2.1 ± 0.5 mm in the balloon group, p < 0.001). At 3 to 6 months of follow-up, a significantly larger lumen diameter was maintained in the start group (2.2 ± 0.6 vs. 1.5 ± 9.7 mm, p < 0.001). The late restenosis rate according to a binary definition was significantly lower to the stent group (13% vs. 39%, p < 0.001). Stenosis exacerbation, frequently observed within 24 h after balloon angioplasty, was not found after stenting. Between the next day and 1 month, regression was dominant in the balloon group, whereas progression of stenosis was observed in the stent group. The greatest tendency to restenosis was observed in both groups between 1 and 3 months after the procedure. Between 3 and 6 months, significantly greater diameter loss was found in the stent group. Conclusions. The Palmaz-Schatz stent was effective in reducing the restenosis rate in this highly selected cobort of patients. Reduction in restenosis rate was dependent on a larger lumen obtained immediately. Late loss of diameter was significantly greater after stenting. The restenosis rate after stenting should be evaluated by follw-up angiography at 6 months rather than at 3 months, which is adequate after conventional balloon angioplasty. © 1993.

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Kimura, T., Nosaka, H., Yokoi, H., Iwabuchi, M., & Nobuyoshi, M. (1993). Serial angiographic follow-up after palmaz-schatz stent implantation: Comparison with conventional balloon angioplasty. Journal of the American College of Cardiology, 21(7), 1557–1563. https://doi.org/10.1016/0735-1097(93)90368-B

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