Serial angiographic follow-up after Palmaz-Schatz stent implantation: comparison with conventional balloon angioplasty
T Kimura,
H Nosaka,
H Yokoi,
M Iwabuchi,
and
M Nobuyoshi
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
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 > or = 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 stent group (2.2 +/- 0.6 vs. 1.5 +/- 0.7 mm, p < 0.001). The late restenosis rate according to a binary definition was significantly lower in 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 cohort 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 follow-up angiography at 6 months rather than at 3 months, which is adequate after conventional balloon angioplasty.
This article has been cited by other articles:
|
|
|
|
 
D. E. Cutlip, S. Windecker, R. Mehran, A. Boam, D. J. Cohen, G.-A. van Es, P. Gabriel Steg, M.-a. Morel, L. Mauri, P. Vranckx, et al.
Clinical End Points in Coronary Stent Trials: A Case for Standardized Definitions
Circulation,
May 1, 2007;
115(17):
2344 - 2351.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Mahmarian, H. A. Dakik, N. G. Filipchuk, L. J. Shaw, S. S. Iskander, T. D. Ruddy, F. Keng, M. J. Henzlova, A. Allam, L. A. Moye, et al.
An Initial Strategy of Intensive Medical Therapy Is Comparable to That of Coronary Revascularization for Suppression of Scintigraphic Ischemia in High-Risk But Stable Survivors of Acute Myocardial Infarction
J. Am. Coll. Cardiol.,
December 19, 2006;
48(12):
2458 - 2467.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Ben-Gal, R. Mohr, R. Braunstein, A. Finkelstein, N. Hansson, A. Hendler, Y. Moshkovitz, and G. Uretzky
Revascularization of Left Anterior Descending Artery With Drug-Eluting Stents: Comparison With Minimally Invasive Direct Coronary Artery Bypass Surgery
Ann. Thorac. Surg.,
December 1, 2006;
82(6):
2067 - 2071.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Ben-Gal, Y. Moshkovitz, N. Nesher, G. Uretzky, R. Braunstein, A. Hendler, E. Zivi, I. Herz, and R. Mohr
Drug-Eluting Stents Versus Coronary Artery Bypass Grafting in Patients with Diabetes Mellitus
Ann. Thorac. Surg.,
November 1, 2006;
82(5):
1692 - 1697.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. E. Rodriguez, J. F. Granada, M. Rodriguez-Alemparte, C. F. Vigo, J. Delgado, C. Fernandez-Pereira, A. Pocovi, A. M. Rodriguez-Granillo, D. Schulz, A. E. Raizner, et al.
Oral Rapamycin After Coronary Bare-Metal Stent Implantation to Prevent Restenosis: The Prospective, Randomized Oral Rapamycin in Argentina (ORAR II) Study
J. Am. Coll. Cardiol.,
April 18, 2006;
47(8):
1522 - 1529.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Moshkovitz, R. Mohr, R. Braunstein, E. Zivi, G. Uretzky, Y. Ben-Gal, and I. Herz
Revascularization of Left Anterior Descending Coronary Artery in Patients With Single and Multivessel Disease: Comparison Between Off-Pump Internal Thoracic Artery and Drug-Eluting Stent
Chest,
August 1, 2005;
128(2):
804 - 809.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. Herz, Y. Moshkovitz, A. Hendler, S. Z. Adam, G. Uretzky, Y. Ben-Gal, and R. Mohr
Revascularization of Left Anterior Descending Artery With Drug-Eluting Stents: Comparison With Off-Pump Surgery
Ann. Thorac. Surg.,
January 1, 2005;
79(1):
88 - 92.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Kimura, K. Abe, S. Shizuta, K. Odashiro, Y. Yoshida, K. Sakai, K. Kaitani, K. Inoue, Y. Nakagawa, H. Yokoi, et al.
Long-Term Clinical and Angiographic Follow-Up After Coronary Stent Placement in Native Coronary Arteries
Circulation,
June 25, 2002;
105(25):
2986 - 2991.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Johansson, H. Olsson, and B. Wennerblom
Angiography-Guided Routine Coronary Stent Implantation Results in Suboptimal Dilatation
Angiology,
January 1, 2002;
53(1):
69 - 75.
[Abstract]
[PDF]
|
|
|
|
|
|
|
F. SCHIELE
The "angioplastically correct" follow up strategy after stent implantation
Heart,
April 1, 2001;
85(4):
363 - 364.
[Full Text]
|
|
|
|
|
|
|
P K Haager, E R Schwarz, J v. Dahl, H G Klues, T Reffelmann, and P Hanrath
Long term angiographic and clinical follow up in patients with stent implantation for symptomatic myocardial bridging
Heart,
October 1, 2000;
84(4):
403 - 408.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
J. Kamenz, W. Seibold, M. Wohlfrom, S. Hanke, N. Heise, C. Lenz, and H. Hanke
Incidence of intimal proliferation and apoptosis following balloon angioplasty in an atherosclerotic rabbit model
Cardiovasc Res,
February 1, 2000;
45(3):
766 - 776.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Betriu, M. Masotti, A. Serra, J. Alonso, F. Fernandez-Aviles, F. Gimeno, T. Colman, J. Zueco, J. L. Delcan, E. Garcia, et al.
Randomized comparison of coronary stent implantation and balloon angioplasty in the treatment of de novo coronary artery lesions (START): A four-year follow-up
J. Am. Coll. Cardiol.,
November 1, 1999;
34(5):
1498 - 1506.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Kasaoka, J. M. Tobis, T. Akiyama, B. Reimers, C. Di Mario, N. D. Wong, and A. Colombo
Angiographic and intravascular ultrasound predictors of in-stent restenosis
J. Am. Coll. Cardiol.,
November 15, 1998;
32(6):
1630 - 1635.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Rodriguez, F. Ayala, V. Bernardi, O. Santaera, E. Marchand, C. Pardinas, C. Mauvecin, D. Vogel, L. C. Harrell, I. F. Palacios, et al.
Optimal coronary balloon angioplasty with provisional stenting versus primary stent (OCBAS): Immediate and long-term follow-up results
J. Am. Coll. Cardiol.,
November 1, 1998;
32(5):
1351 - 1357.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Ozaki, D. Keane, P. Ruygrok, W. J. van der Giessen, P. de Feyter, and P. W. Serruys
Six-Month Clinical and Angiographic Outcome of the New, Less Shortening Wallstent in Native Coronary Arteries
Circulation,
June 15, 1996;
93(12):
2114 - 2120.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
T. Kimura, H. Yokoi, Y. Nakagawa, T. Tamura, S. Kaburagi, Y. Sawada, Y. Sato, H. Yokoi, N. Hamasaki, H. Nosaka, et al.
Three-Year Follow-Up after Implantation of Metallic Coronary-Artery Stents
N. Engl. J. Med.,
February 29, 1996;
334(9):
561 - 567.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Hall, S. Nakamura, L. Maiello, A. Itoh, S. Blengino, G. Martini, M. Ferraro, and A. Colombo
A Randomized Comparison of Combined Ticlopidine and Aspirin Therapy Versus Aspirin Therapy Alone After Successful Intravascular Ultrasound–Guided Stent Implantation
Circulation,
January 15, 1996;
93(2):
215 - 222.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
A. Colombo, P. Hall, S. Nakamura, Y. Almagor, L. Maiello, G. Martini, A. Gaglione, S. L. Goldberg, and J. M. Tobis
Intracoronary Stenting Without Anticoagulation Accomplished With Intravascular Ultrasound Guidance
Circulation,
March 15, 1995;
91(6):
1676 - 1688.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
A. E. Rodriguez, O. Santaera, M. Larribau, M. Fernandez, R. Sarmiento, N. P. Balino, J. B. Newell, G. S. Roubin, and I. F. Palacios
Coronary Stenting Decreases Restenosis in Lesions With Early Loss in Luminal Diameter 24 Hours After Successful PTCA
Circulation,
March 1, 1995;
91(5):
1397 - 1402.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
C. Landau, R. A. Lange, and L. D. Hillis
Percutaneous Transluminal Coronary Angioplasty
N. Engl. J. Med.,
April 7, 1994;
330(14):
981 - 993.
[Full Text]
|
|
|
|
|
|
|
DOES STENTING REDUCE RESTENOSIS, OR ONLY DELAY IT?
Journal Watch (General),
June 11, 1993;
1993(611):
3 - 3.
[Full Text]
|
|
|
|
