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Effectiveness of coronary stent deployment without predilation

1999; Elsevier BV; Volume: 84; Issue: 1 Linguagem: Inglês

10.1016/s0002-9149(99)00198-8

1879-1913

Itzhak Herz, Abid Assali, Alejandro Solodky, Nurit Shor, Avraham Pardes, Tuvia Ben‐Gal, Yehuda Adler,

Cardiac and Coronary Surgery Techniques

Intracoronary stenting reduces abrupt vessel closure and the immediate need for bypass surgery secondary to failed coronary angioplasty. 1 Eekhout E Kappenberger L Goy J Stents for intracoronary placement. Current status and future directions. J Am Coll Cardiol. 1996; 27: 757-765 Abstract Full Text PDF PubMed Scopus (93) Google Scholar , 2 Carrozza Jr, J.P Baim D Coronary stenting. in: Baim C Grossman W Cardiac Catheterization Angiography and Intervention. 5th Ed. Williams & Wilkins, Maryland, USA1996: 617-639 Google Scholar Stents may be used in patients at high risk for acute closure and to reduce the rate of restenosis. 3 Fischman D.L Leon M.B Bain D.S Schatz R Savage M.P Penn I Detre K Veltri L Ricci D Nobuyoshi M et al. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med. 1994; 331: 496-501 Crossref PubMed Scopus (4125) Google Scholar , 4 Serruys P.N de Jaegere P Kiemenir F Macaya C Rutsch W Heyndrickx G Emanuelsson H Marco J Legrand V Materne P et al. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. N Engl J Med. 1994; 331: 489-495 Crossref PubMed Scopus (4353) Google Scholar , 5 Kimura T Yokoi H Hamasaki N Nosada H Nobuyoshi M Three-year follow-up after implantation of metallic coronary-artery stents. N Engl J Med. 1996; 334: 561-566 Crossref PubMed Scopus (476) Google Scholar The standard deployment of coronary stents requires prior dilation of the stenotic lesion by balloon or debulking devices. Due to recent advances in stent design, 6 Ozaki Y Violaris A.G Serruys P.W New stent technologies. Prog Cardiovasc Dis. 1996; 39: 129-140 Abstract Full Text PDF PubMed Scopus (36) Google Scholar predilation may not be necessary in all cases, thus shortening the duration of the procedure, the radiation time, and reducing procedural related costs. Recent studies have shown that stents used without balloon predilation may provide a means for dilating arteries while avoiding complete endothelial ablation, leading to less neointimal hyperplasia and a lower rate of restenosis. 7 Bonan R Paiement P Scortichini D Cloutier M.J Leung T.K Coronary restenosis in a swine model evaluation of restenosis injury index. Am Heart J. 1993; 126: 1334-1340 Abstract Full Text PDF PubMed Scopus (55) Google Scholar , 8 Hoffmann R Minz G.S Dussaillant G.R Popma J.J Pichard A.D Satler L.F Kent K.M Griffin L Leon M.B Patterns and mechanisms of in-stent restenosis. A serial intravascular ultrasound study. Circulation. 1996; 94: 1247-1254 Crossref PubMed Scopus (1230) Google Scholar , 9 Rogers C Parikh S Seifert P Edelman E.R Endogenous cell seeding remnant endothelium after stenting enhances vascular repair. Circulation. 1996; 94: 2909-2914 Crossref PubMed Scopus (204) Google Scholar We hypothesized that coronary stenting without predilation strategy would be feasible in a large number of patients undergoing coronary artery stenting.