title: Angiographic Results and Late Clinical Outcomes Utilizing a Stent Synergy (Pre-Stent Atheroablation) Approach in Complex Lesion Subsets.
abstract: To investigate the strategy of ÒdebulkingÓ in complex lesions before stent implantation (stent synergy) to improve procedural safety and achieve optimal acute and long-term results, we reviewed our experience in 389 patients with 504 lesions undergoing a combined stent procedure (45% rotational atherectomy, 24% laser angioplasty, 20% directional atherectomy, and 11% transluminal extraction atherectomy before stent implantation). Procedural success was achieved in 94.5%, with 4% major ischemic complications (1.1% death, 1.9% Q-wave myocardial infarction, and 2.3% emergency coronary artery bypass surgery). Overall, subacute stent thrombosis occurred in 1.5% of patients. Target-lesion revascularization during follow-up was required in 9.8% of the patients. We conclude that a strategy of selective pre-stent atheroablation in complex lesion subsets results in excellent procedural outcomes with acceptable complications and favorable long-term results.
authors.affiliation: 110 Irving Street, N.W., (4B-1), Washington, D.C., 20010, USA.
authors.initials: MK
authors.lastname: Hong
authors.initials: GS
authors.lastname: Mintz
authors.initials: JJ
authors.lastname: Popma
authors.initials: KM
authors.lastname: Kent
authors.initials: AD
authors.lastname: Pichard
authors.initials: LF
authors.lastname: Satler
authors.initials: SC
authors.lastname: Wong
authors.initials: T
authors.lastname: Bucher
authors.initials: MB
authors.lastname: Leon