Successful coronary stenting without warfarin or intravascular ultrasound.
Although warfarin is typically recommended in the management of patients following coronary stent implantation, several studies have suggested a reduced incidence of subacute thrombosis if the antiplatelet drug ticlopidine is employed instead. Postdilatation with a high pressure balloon catheter is now commonly performed following stent deployment. However, there is uncertainty whether intravascular ultrasound is important in assessing adequacy of stent expansion. Some investigators have proposed a set of ultrasound criteria that need to be met in order to achieve optimal stent deployment. Others have reported low rates of subacute stent thrombosis using empiric high pressure postdilatation rather than an ultrasound-guided strategy. We retrospectively studied 100 consecutive patients in a single institution who received coronary stents for a variety of indications. No patient received warfarin or intravascular ultrasound, and all were followed for a minimum of six weeks. Subacute stent thrombosis did not occur in any patient. We conclude that an excellent result can be routinely obtained in stented patients without the use of intravascular ultrasound.
Warner
M F
MF
Cardiac Catheterization Laboratory, St. Francis Hospital and Medical Center, Hartford, CT 06105, USA.
Nathaniel
C
C
Missri
J C
JC
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods; D000925:Anticoagulants / Q000627:therapeutic use; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin