title: Facilitated stent delivery using applied topical lubrication.
abstract: OBJECTIVE
  The goal of this study was to assess the utility of topical lubrication to aid stent delivery in challenging anatomy and its effects on long-term clinical outcome.
  
  
  BACKGROUND
  Failed stent delivery is encountered in up to 5% of percutaneous coronary interventions (PCI).
  
  
  METHODS
  The effectiveness of topically applied lubrication to facilitate stent delivery after failed stent placement was evaluated in 20 (2.5%) out of 813 consecutive patients undergoing PCI. Initial attempts at stent delivery failed despite balloon predilatation and use of moderate-to-stiff guidewires in all patients. The lubricious solution used was Rotaglide, a phospholipid emulsion originally designed to reduce catheter friction during rotational atherectomy. Following unsuccessful delivery, stents were removed from the guiding catheters, topically saturated with Rotaglide, and deployment immediately reattempted. Procedural efficacy and long-term clinical outcomes were assessed.
  
  
  RESULTS
  The study population included 20 patients aged 69 +/- 10 years, all of whom had complex lesions (ACC/AHA Class B(2) or C). Rotaglide lubricated stents were successfully deployed at the target lesions in 17 of the 20 patients (85%). Patients were followed 19.5 +/- 3.2 months after their index procedure. There were no periprocedural complications or subacute stent thromboses. Of the 14 patients with drug-eluting stents, none had clinical restenosis or target vessel revascularization. Target lesion revascularization secondary to restenosis was required in 1 of 3 patients treated with bare-metal stents.
  
  
  CONCLUSIONS
  Topical lubrication is a simple and effective aid for stent delivery in complex lesions. Rotaglide appears safe and biocompatible with drug-eluting stents.
authors.affiliation: Division of Cardiology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA.
authors.forename: Alok
authors.initials: A
authors.lastname: Singh
authors.forename: Mark
authors.initials: M
authors.lastname: Awar
authors.forename: Adeeb
authors.initials: A
authors.lastname: Ahmed
authors.forename: David L
authors.initials: DL
authors.lastname: Fischman
authors.forename: Paul
authors.initials: P
authors.lastname: Walinsky
authors.forename: Michael P
authors.initials: MP
authors.lastname: Savage
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D023921:Coronary Stenosis / Q000628:therapy*; D004655:Emulsions; D005260:Female; D006801:Humans; D008153:Lubrication; D008297:Male; D015607:Stents; D017211:Treatment Failure
chemical_list: D004655:Emulsions