[Coronary artery stenting without antivitamin K. Results after a month].
This paper reports experience with a new antithrombotic agent prescribed to reduce the incidence of subacute occlusions during the first month after coronary stenting. Therefore, a powerful association of platelet antiaggregant agents was tested. From December 1992 to October 1994, coronary stenting was successfully achieved in 1,294 patients (1,118 men, average age 60.5 +/- 10 years) who were then treated with the association of ticlopidine 0.25 g/day and aspirin 0.10 g/day for one month. This was covered with anticoagulation with a low molecular weight heparin for a variable period (one month, two weeks, then one week), according to the different phases of the study protocol. In all, 1487 stents were successfully implanted (1,330 Palmaz Schatz; 63 Cook; 80 Wictor; 13 AVE and 1 Strecker) in 1,326 vessels (520 left anterior descending, 208 left circumflex, 475 right coronary, 16 left main coronary arteries and 107 venous grafts) using balloon catheters of 2.5 mm to 5 mm diameter for average 3.45 +/- 0.4 mm). Major complications in the first month included 9 deaths (0.7%), 22 occlusions (1.7%): 14 myocardial infarcts (1%) and 11 aorto-coronary bypass procedures (0.85%). There were 136 local haematomas or false aneurysms (10.5%), 42 of which (3.25%) required blood transfusion or surgical repair. This multicenter trial of a protocol associating platelet antiaggregant agents and low molecular weight heparin for one month showed a low incidence of subocclusion after coronary stenting (1.7 +/= 2.5%) and should enable interventional cardiologists to widen the indications for coronary stenting.
Zemour
G
G
Service de cardiologie, centre hospitalier Victor-Durouy, Argenteuil.
Morice
M C
MC
Benveniste
E
E
Biron
Y
Y
Lienhart
Y
Y
Valeix
B
B
Louvard
Y
Y
Glatt
B
B
Lefevre
T
T
Guérin
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003327:Coronary Disease / Q000628:therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000401:mortality / Q000517:prevention & control; D013988:Ticlopidine / Q000627:therapeutic use; D016896:Treatment Outcome
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine; D001241:Aspirin
Implantation de prothèses endocoronaires sans antivitamine K. Résultats à un mois.