Late coronary artery stenosis regression within the Gianturco-Roubin intracoronary stent.
The late angiographic outcome of the Gianturco-Roubin intracoronary stent has not been well defined. To investigate serial changes within the stent, we studied 23 patients (15 men and 8 women, median age 63) who had late angiographic follow-up ( > 1 year) after undergoing Gianturco-Roubin stenting for angioplasty-associated acute or threatened native coronary artery closure. Coronary angiography before and after stenting, at 6-month follow-up, and at late return was analyzed with quantitative coronary angiography. The median time from stent deployment to late angiographic follow-up was 27 months. As expected, stenting significantly increased the median minimal lumen diameter (MLD) acutely from 1.0 to 2.46 mm. Median percent diameter stenosis decreased from 66% to 18%. Although at 6 months there was a significant loss of the acute gain (median MLD decreased from 2.46 to 1.9 mm), with a corresponding increase in percent stenosis from 18% to 31%, late angiography demonstrated lesion regression, median MLD increasing from 1.9 to 2.15 mm (p = 0.004), and percent stenosis decreasing from 31% to 21% (p = 0.0026). No patient had a significant decline in minimal lesion diameter, and 5 patients had a > 50% increase in MLD at late follow-up. Linear regression analysis of 6-month MLD and late lumen gain suggested that lesions with the greatest regression were those with the lowest lumen diameters at 6-month angiography. Late angiographic analysis demonstrated significant lesion regression within the Gianturco-Roubin stent, which was sometimes dramatic. In suggesting that coronary arteriography at 6 months may underestimate the late angiographic benefit of intracoronary stenting, these data have important clinical implications, and imply that patients with a stable clinical course and angiographic stent restenosis may often be followed rather than routinely redilated.
Hermiller
J B
JB
Nasser, Smith & Pinkerton Inc., Indianapolis, Indiana, USA.
Fry
E T
ET
Peters
T F
TF
Orr
C M
CM
Van Tassel
J
J
Waller
B
B
Pinkerton
C A
CA
D015906:Angioplasty, Balloon, Coronary; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000628:therapy; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015607:Stents