title: Primary stenting of occluded native coronary arteries: final results of the Primary Stenting of Occluded Native Coronary Arteries (PRISON) study.
abstract: BACKGROUND
  Primary intracoronary stent placement after successfully crossing chronic total coronary occlusions may decrease the high restenosis rate at long-term follow-up compared with conventional balloon angioplasty.
  
  
  METHODS
  In a prospective, randomized trial, balloon angioplasty was compared with stent implantation for the treatment of chronic total occlusions. Patients were followed for 12 months with angiographic follow-up at 6 months. Quantitative coronary analysis was performed by an independent core lab.
  
  
  RESULTS
  A total of 200 patients were enrolled. Baseline characteristics were evenly distributed. After the procedure the mean minimal luminal diameter in the conventional group was 2.34 +/- 0.46 mm versus 2.90 +/- 0.41 mm in the stented group (P <.0001). The 6-month angiographic follow-up showed a mean minimal luminal diameter of 1.57 +/- 0.74 mm in the conventional group versus 1.93 +/- 0.85 mm in the stented group (P =.009) and a mean diameter stenosis of 44.7% +/- 25.0% versus 35.5% +/- 26.5% (P =.036). Binary angiographic restenosis (>50% diameter stenosis) was seen in 33% in the conventional group versus 22% in the stented group (P =.137). The reocclusion rates were 7.3% and 8.2%, respectively (P = 1.00). At 12 month follow-up, the rate of target lesion revascularization was significantly higher in the conventional group (29% versus 13%, P <.0001).
  
  
  CONCLUSIONS
  These data demonstrate that stenting of chronic total occlusions is superior to balloon angioplasty alone with a statistically significant reduction in the need for target lesion revascularization and a lower, but not significant, restenosis rate.
authors.affiliation: St Antonius Hospital Nieuwegein, Nieuwegein, The Netherlands.
authors.forename: Braim M
authors.initials: BM
authors.lastname: Rahel
authors.forename: Maarten J
authors.initials: MJ
authors.lastname: Suttorp
authors.forename: Gert J
authors.initials: GJ
authors.lastname: Laarman
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Kiemeneij
authors.forename: Egbert T
authors.initials: ET
authors.lastname: Bal
authors.forename: Benno J
authors.initials: BJ
authors.lastname: Rensing
authors.forename: Sjef M P G
authors.initials: SM
authors.lastname: Ernst
authors.forename: Jurriën M
authors.initials: JM
authors.lastname: ten Berg
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Kelder
authors.forename: H W Thijs
authors.initials: HW
authors.lastname: Plokker
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D002908:Chronic Disease; D017023:Coronary Angiography; D003327:Coronary Disease / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D013223:Statistics as Topic; D015607:Stents