Complications and follow-up after intracoronary stenting: critical analysis of a 6-year single-center experience.
From April 1986 through April 1992, 123 patients received 153 intracoronary stents (131 Medinvent, 13 Palmaz-Schatz, 9 Wiktor) during 131 procedures. The indication was bail-out treatment in 39, restenosis in 59 native coronary arteries, and stenosis or restenosis in 33 vein grafts. Stent-related events were studied during the in-hospital stay and on follow-up and included closure, stent restenosis, myocardial infarction, death, and the need for coronary bypass surgery. A Kaplan-Meier estimate extended to 6 years showed different short- and long-term outcomes for the distinct treatment groups (p < 0.05): right coronary artery stenting (more particularly, stenting for restenosis after angioplasty) had the lowest and vein graft stenting had the highest stent-related complication rate. The complication rate was similar (p > 0.25) (1) in the case of multiple nontandem stent implantation during the same procedure; (2) for the different endoprosthesis sizes; and (3) during the different procedural years. In native coronary arteries, restenosis after angioplasty of the right coronary artery could be a preferential indication for coronary artery stenting. Despite a favorable short-term outcome, vein graft stenting has a high incidence of events on long-term follow-up, mainly because of late restenosis. Multiple nontandem stenting during the same procedure is not associated with a higher incidence of complications, in particular, the restenosis rate is not appreciably higher. Finally, only a minor benefit for the learning curve is apparent from this single-center experience with continual unchanged postprocedural management.
Eeckhout
E
E
Department of Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Goy
J J
JJ
Vogt
P
P
Stauffer
J C
JC
Sigwart
U
U
Kappenberger
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology; D003331:Coronary Vessels / Q000473:pathology*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D012008:Recurrence; D012501:Saphenous Vein / Q000473:pathology / Q000637:transplantation; D015607:Stents / Q000009:adverse effects*