Intracoronary Stenting for Restenosis: Long-Term Follow-up: A Single Center Experience.
One-hundred thirteen stents (78 Wallstents, 29 Palmaz-Schatz and 6 Wiktor) were implanted in 106 patients aged 63 +/- 5 years to treat a restenosis following previous angioplasty in a native coronary artery (86 cases) and in a venous graft (20 cases). Implantation was technically possible in all cases. The native vessels had a mean reference diameter of 3.3 +/- 0.3 mm and their mean minimal lumen diameter increased from 1.2 +/- 0.3 mm before angioplasty to 2.8 +/- 0.8 after stent implantation. The venous grafts mean reference diameter was 4.4 +/- 0.7 mm and their mean minimal lumen diameter increased from 1.3 +/- 0.4 mm before angioplasty to 4.0 +/- 0.7 mm after implantation. Percentage stenosis in the native arteries and in the venous grafts were respectively 78 +/- 13% and 69 +/- 14% before angioplasty and 24 +/- 8% and 22 +/- 8% after stent implantation. Complications at 6 months, presented as a ranking scale with 100% follow-up rate were, overall, of 20% clinical events (4% deaths, 6% myocardial infractions, 2% coronary artery bypass grafting and 8% re-angioplasty). Angiographic complications were of 8% subacute thrombosis and 19% restenosis and chronic occlusions. Long-term, at 65 +/- 9 months, clinical (86% follow-up) and angiographic (74% follow-up) showed that only a further 9% clinical events and 14% restenosis (12% of them between 6 and 12 months) occurred after 6 months. At an estimated follow-up time of 104 months, 70% patients remain event-free and the survival rate is 95%. In conclusion, stent implantation in the treatment of restenosis following conventional balloon angioplasty is a valid strategy with good long-term results.
Debbas
NM
Division de Cardiologie, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon, 1011, Lausanne, Switzerland.
Sigwart
U
Eeckhout
E
Stauffer
JC
Karpuz
H
Vogt
P
Kappenberger
L
Goy
JJ