Coronary implantation of silicone-carbide-coated Palmaz-Schatz stents in patients with high risk of stent thrombosis without oral anticoagulation.
Coronary stenting in bail-out situations is effective but associated with increased stent thrombosis and bleeding rates. Silicone-carbide coating reduces fibrinogen activation on alloplastic surfaces and thus may also reduce stent thromboses. A total of 44 patients received 58 silicone-carbide-coated stents for threatened (80%) or abrupt (20%) closure. In addition to heparin, patients were treated with aspirin and ticlopidine (75%) or aspirin (25%) only. Two patients (4.5%) died in the hospital. The combined in-hospital complication rate including death, emergency revascularization, stent-related myocardial infarction, and stent thrombosis was 9% (4 of 44 patients). Major bleeding occurred in 4 patients (9%). Six-month follow-up angiography was obtained in all eligible patients (42 of 44), revealing a restenosis rate of 21% (9 of 42). Thus, coronary implantation of silicone-carbide-coated stents is feasible in bail-out situations without oral anticoagulation and with a low complication rate. Further studies are required to optimize the anticoagulation regimen with this type of coating.
Ozbek
C
C
University Clinic of the Saarland, Division of Internal Medicine III (Department of Cardiology and Angiology), Homburg, Germany.
Heisel
A
A
Gross
B
B
Bay
W
W
Schieffer
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D000925:Anticoagulants / Q000008:administration & dosage; D002244:Carbon; D017554:Carbon Compounds, Inorganic; D002423:Cause of Death; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D004630:Emergencies; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D019233:Retreatment; D017655:Silicon Compounds; D015607:Stents; D013499:Surface Properties; D015996:Survival Rate
D000925:Anticoagulants; D017554:Carbon Compounds, Inorganic; D017655:Silicon Compounds; D002244:Carbon; C022088:silicon carbide