Heparin-coated versus uncoated Palmaz-Schatz stent in native coronary circulation. A randomized study with blind angioscopic assessment.
The increasing use of stenting to treat more complex lesions and highly thrombogenic situations still carries higher risk for subacute stent thrombosis. To assess new heparin-coated stents in a more stringent reality, 40 consecutive patients were randomized in 1:1 ratio to receive either heparin-coated (group 1, 25 stents) or uncoated Palmaz-Schatz stents (group 2, 32 stents). The two groups were similar in baseline clinical, pre-and post-procedural angiographic and angioscopic characteristics. High pressure stent deployment without intravascular ultrasound guidance was used. All pts received antiplatelet agents alone. We applied serial angioscopy (baseline and on 7th day) to evaluate thrombus formation and quantitative coronary angiography (QCA) to define late (6 months, n=39, 100% the eligible pts) neointimal regrowth. There was one subacute stent thrombosis with subsequent acute myocardial infarction and death in the uncoated group.


CONCLUSIONS
The implantation of heparin-coated stents in nonselected population is well tolerated and associated with no clinical or angioscopic evidence of new thrombus formation, resulting in favorable long-term clinical and angiographic outcome.
Kedev
S
S
Institute for Heart Disease, Skopje Medical University, Republic of Macedonia. skedev@mt.net.mk
Guagliumi
G
G
Valsechi
O
O
Tespili
M
M
D000925:Anticoagulants / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy*; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D015607:Stents; D016896:Treatment Outcome
D000925:Anticoagulants; D020099:Coated Materials, Biocompatible; D006493:Heparin