Stenting vs. balloon angioplasty with provisional stenting for the treatment of vessels with small reference diameter.
A consecutive series of interventions in vessels with reference diameter < or = 2.75 mm was retrospectively analyzed according to preprocedure strategy: balloon angioplasty with provisional stenting (PTCA group, 73 patients) and primary stenting (PS group, 122 patients). In the PS group, there were more patients with single-vessel disease (54.1% vs. 37.0%; P = 0.021), less patients with three-vessel disease (9.0% vs. 24.7%; P = 0.003), more LAD interventions (54.9% vs. 31.5; P = 0.002), and less left circumflex interventions (22.1% vs. 45.2%; P < 0.001). Reference diameter was larger in the PS group (2.28 +/- 0.35 mm vs. 2.11 +/- 0.36 mm; P = 0.001). Provisional stenting was performed in 39.7% of PTCA group. At long-term outcome, the incidence of composite major events was similar between the PTCA and the PS groups (20.5% vs. 17.2%, respectively; P = NS). Treatment of small vessels with balloon dilatation and provisional stenting or with primary stenting yielded similar late outcomes. Operators' choice of treatment strategy was based on particular angiographic characteristics.
Lemos
Pedro A
PA
Catheterization Laboratory, Heart Institute (InCor) of University of Sao Paulo Medical School, Sao Paulo, Brazil.
Martinez
Eulogio E
EE
Quintella
Edgard
E
Harrell
Lari C
LC
Ramires
Jose A F
JA
Ribeiro
Expedito E
EE
da Gama
Marcus N
MN
Horta
Pedro E
PE
Kajita
Luiz J
LJ
Esteves
Antonio
A
Perin
Marco A
MA
Soares
Paulo R
PR
Zalc
Silvio
S
Palacios
Igor F
IF
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome