title: Treatment of ostial lesions of the left anterior descending coronary artery with Palmaz-Schatz coronary stent.
abstract: We evaluated acute and long-term clinical and angiographic results of elective Palmaz-Schatz coronary stent implantation for left anterior descending coronary artery (LAD) ostial stenosis in 23 consecutive patients. Eight patients had stable angina, 14 had unstable angina, and 1 had recent myocardial infarction. Sixteen patients had single-vessel, 5 had double-vessel, and 2 had triple-vessel disease. Clinical success without major complications (death, acute myocardial infarction, emergency coronary artery bypass grafting) was obtained in all cases and technical success in 20 cases (86.9%). After stenting, minimal lumen diameter increased from 1.05 +/- 0.45 mm to 2.89 +/- 0.52 mm (p < 0.001), and percent diameter stenosis decreased from 65.49% +/- 13.36% to 2.94% +/- 19.93% (p < 0.001). One case of subacute thrombosis and no major bleeding occurred. Twenty patients were followed-up for 6 months, during which no acute cardiac event (death, acute myocardial infarction) was observed. Eighteen patients were eligible for follow-up coronary angiography; restenosis (> or = 50% diameter stenosis) was observed in 4 (22.2%). Minimal lumen diameter was 1.77 +/- 0.55 mm, percent diameter stenosis was 39.66% +/- 17.62%, late loss was 1.01 +/- 0.69 mm, net gain was 0.79 +/- 0.55 mm, and loss index (late loss/acute gain) was 0.53 +/- 0.37. This study suggests that elective Palmaz-Schatz stent implantation may be a safe and successful treatment of LAD ostial lesions and provides a large increase in lumen diameter.
authors.affiliation: Institute of Cardiology, Monzino Foundation, IRCCS, Milan, Italy.
authors.forename: N B
authors.initials: NB
authors.lastname: De Cesare
authors.forename: A L
authors.initials: AL
authors.lastname: Bartorelli
authors.forename: S
authors.initials: S
authors.lastname: Galli
authors.forename: A
authors.initials: A
authors.lastname: Loaldi
authors.forename: F
authors.initials: F
authors.lastname: Fabbiocchi
authors.forename: P
authors.initials: P
authors.lastname: Sganzerla
authors.forename: P
authors.initials: P
authors.lastname: Montorsi
authors.forename: M D
authors.initials: MD
authors.lastname: Guazzi
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome