Stenting in Chronic Coronary Occlusion (SICCO): a randomized, controlled trial of adding stent implantation after successful angioplasty
PA Sirnes,
S Golf,
Y Myreng,
P Molstad,
H Emanuelsson,
P Albertsson,
M Brekke,
A Mangschau,
K Endresen,
and
J Kjekshus
Feiring Heart Clinic, Norway.
OBJECTIVES: This study investigated whether stenting improves long-term results after recanalization of chronic coronary occlusions. BACKGROUND: Restenosis is common after percutaneous transluminal coronary angioplasty (PTCA) of chronic coronary occlusions. Stenting has been suggested as a means of improving results, but its use has not previously been investigated in a randomized trial. METHODS: We randomly assigned 119 patients with a satisfactory result after successful recanalization by PTCA of a chronic coronary occlusion to 1) a control (PTCA) group with no other intervention, or 2) a group in which PTCA was followed by implantation of Palmaz-Schatz stents with full anticoagulation. Coronary angiography was performed before randomization, after stenting and at 6-month follow-up. RESULTS: Inguinal bleeding was more frequent in the stent group. There were no deaths. One patient with stenting had a myocardial infarction. Subacute occlusion within 2 weeks occurred in four patients in the stent group and in three in the PTCA group. At follow-up, 57% of patients with stenting were free from angina compared with 24% of patients with PTCA only (p < 0.001). Angiographic follow-up data were available in 114 patients. Restenosis (> or = 50% diameter stenosis) developed in 32% of patients with stenting and in 74% of patients with PTCA only (p < 0.001); reocclusion occurred in 12% and 26%, respectively (p = 0.058). Minimal lumen diameter (mean +/- SD) at follow-up was 1.92 +/- 0.95 mm and 1.11 +/- 0.78 mm, respectively (p < 0.001). Target lesion revascularization within 300 days was less frequent in patients with stenting than in patients with PTCA only (22% vs. 42%, p = 0.025). CONCLUSIONS: Stent implantation improved long-term angiographic and clinical results after PTCA of chronic coronary occlusions and is thus recommended regardless of the primary PTCA result.
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J. Am. Coll. Cardiol.,
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90 - 96.
[Abstract]
[Full Text]
[PDF]
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M. E. Pfusterer, P. Buser, S. Osswald, P. Weiss, J. Bremerich, and F. Burkart
Time dependence of left ventricular recovery after delayed recanalization of an occluded infarct-related coronary artery: findings of a pilot study
J. Am. Coll. Cardiol.,
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32(1):
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[Abstract]
[Full Text]
[PDF]
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D. R. Yu, R. Miller, and P. F. Bray
Through Thick and Thin
N. Engl. J. Med.,
June 4, 1998;
338(23):
1684 - 1687.
[Full Text]
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K K HAASE, A BAUMBACH, and K R KARSCH
Stents are used too often
Heart,
June 1, 1998;
79(6):
541 - 542.
[Full Text]
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C. R. Narins, D. R. Holmes Jr, and E. J. Topol
A Call for Provisional Stenting : The Balloon Is Back!
Circulation,
April 7, 1998;
97(13):
1298 - 1305.
[Full Text]
[PDF]
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J Hancock, M R Thomas, S Holmberg, R J Wainwright, and D E Jewitt
Randomised trial of elective stenting after successful percutaneous transluminal coronary angioplasty of occluded coronary arteries
Heart,
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79(1):
18 - 23.
[Abstract]
[Full Text]
[PDF]
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I. Moussa, B. Reimers, J. Moses, C. Di Mario, L. Di Francesco, M. Ferraro, and A. Colombo
Long-term Angiographic and Clinical Outcome of Patients Undergoing Multivessel Coronary Stenting
Circulation,
December 2, 1997;
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3873 - 3879.
[Abstract]
[Full Text]
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Stents Better in Chronic Occlusions
Journal Watch Cardiology,
January 27, 1997;
1997(127):
5 - 5.
[Full Text]
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