title: Self-expanding stent for complex percutaneous coronary interventions: A real life experience.
abstract: OBJECTIVE
  Self-expanding stents represent a re-emerging option for percutaneous coronary interventions. Their application covers a wide spectrum of angiographic situations, i.e., coronary bifurcations, acute coronary syndromes with large thrombotic burden and stenosis of ectatic coronaries. We review our experience with self-expanding stents for different clinical and angiographic indications, with long clinical follow-up.
  
  
  METHODS
  From 2011 to 2013 we used self-expanding STENTYS® stents in 40 consecutive patients followed-up for death from any cause and from cardiovascular cause, myocardial infarction, target lesion revascularization (TLR), stent thrombosis (mean 21±13months). We also revised rate of procedural outcomes, acute stent thrombosis and TLR in patients treated with conventional stents for similar clinical/angiographic situations, in the same period at our institution.
  
  
  RESULTS
  We identified three anatomical settings of STENTYS® use: coronary bifurcations with proximal/distal main branch diameter discrepancy (55% of cases), massive thrombotic burden in the setting of acute coronary syndrome (35% of cases) and stenosis of ectatic coronaries (15%). We observed one death related to acute heart failure and 1 case (2.5%) of acute stent thrombosis (2.5% in the control group). During follow-up 2 cases of stent restenosis leading to TLR (5%) occurred (6.25% in the control group).
  
  
  CONCLUSIONS
  According to our real life experience, self-expanding STENTYS® stents appear to be an effective tool for different angiographic situations in which they may be preferable to balloon-expandable stents, showing a low rate of complications and good results at long term follow-up.
authors.affiliation: Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy; Life Sciences Institute - Scuola Superiore Sant'Anna, Pisa, Italy. Electronic address: pastormerlo@ftgm.it.
authors.forename: Luigi Emilio
authors.initials: LE
authors.lastname: Pastormerlo
authors.affiliation: Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ciardetti
authors.affiliation: Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Coceani
authors.affiliation: Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trianni
authors.affiliation: Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Ravani
authors.affiliation: Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Vaghetti
authors.affiliation: Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Rizza
authors.affiliation: Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: De Caterina
authors.affiliation: Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Berti
authors.affiliation: Division of Interventional Cardiology, Fondazione G. Monasterio CNR-Regione Toscana, Pisa-Massa, Italy.
authors.forename: Cataldo
authors.initials: C
authors.lastname: Palmieri
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology; D004108:Dilatation, Pathologic; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: Coronary artery ectasia; Coronary bifurcations; Self-expanding stent; Thrombotic burden