Angiographic Follow-up after Intracoronary Stenting with Flexible Coil(Gianturco-Roubin) Stent

BACKGROUND: Intracoronary stent with various designs have been developed to treat dissections or acute closure after angioplasty. The efficacy of flexible coil stent as a bail-out device has been reported. However, the restenosis after stenting still remained as a main limitation like other devices. This study reports on the angiographic follow-up after successful intracoronary stenting with flexible coil stent. METHOD: From April 1993 through July 1994, coronary stenting was tried in 21 patients by a single operator for various indications(acute or threatened closure, suboptimal result after balloon angioplasty). The nineteen(95%) out of 20 patients in whom stent was successfully deployed underwent follow-up coronary angiography 7.6+/-3.0 months after coronary stenting. RESULT: Mean age was 54.7+/-11.3(33-73) years and 16 parients were men. Clinical diagnosis of patients were as follows : stable angina 7, unstable angina 6, old myocardial infarction with stable angina 6 and acute myocardial infarction in 1 patient, respectively. Stents were implanted at left anterior descending artery in 9, left circumflex artery in 5 and right coronary artery in 8. Ten out of 21 stents(47.6%) were found to be renarrowed more than 50% at follow-up coronary angiography. There was no significant difference in clinical and angiographic variables between restenosis group and no-restenosis group. Coronary artery bypass graft surgery was performed in 1 patient for the treatment of restenosis after stenting. Repeat PTCA was performed in 3 patients and remaining 5 patients were followed medically. CONCLUSION: Flexible coil(Gianturco-Roubin) coronary stent is a useful adjunct percutaneous intervention to prevent or minimize complicatioms associated with dissections. Despite favorable initial angiographic and clinical results, 47.6% of stents were found to be renarrowed significantly at follow-up coronary angiography. New techniques or more optimal characters of stents would be desired.

Angiographic Follow-up after Intracoronary Stenting with Flexible Coil(Gianturco-Roubin) Stent

BACKGROUND: Intracoronary stent with various designs have been developed to treat dissections or acute closure after angioplasty. The efficacy of flexible coil stent as a bail-out device has been reported. However, the restenosis after stenting still remained as a main limitation like other devices. This study reports on the angiographic follow-up after successful intracoronary stenting with flexible coil stent. METHOD: From April 1993 through July 1994, coronary stenting was tried in 21 patients by a single operator for various indications(acute or threatened closure, suboptimal result after balloon angioplasty). The nineteen(95%) out of 20 patients in whom stent was successfully deployed underwent follow-up coronary angiography 7.6+/-3.0 months after coronary stenting. RESULT: Mean age was 54.7+/-11.3(33-73) years and 16 parients were men. Clinical diagnosis of patients were as follows : stable angina 7, unstable angina 6, old myocardial infarction with stable angina 6 and acute myocardial infarction in 1 patient, respectively. Stents were implanted at left anterior descending artery in 9, left circumflex artery in 5 and right coronary artery in 8. Ten out of 21 stents(47.6%) were found to be renarrowed more than 50% at follow-up coronary angiography. There was no significant difference in clinical and angiographic variables between restenosis group and no-restenosis group. Coronary artery bypass graft surgery was performed in 1 patient for the treatment of restenosis after stenting. Repeat PTCA was performed in 3 patients and remaining 5 patients were followed medically. CONCLUSION: Flexible coil(Gianturco-Roubin) coronary stent is a useful adjunct percutaneous intervention to prevent or minimize complicatioms associated with dissections. Despite favorable initial angiographic and clinical results, 47.6% of stents were found to be renarrowed significantly at follow-up coronary angiography. New techniques or more optimal characters of stents would be desired.

Early Clinical Experience with Flexible Coil(Gianturco-Roubin) Coronary Stent

BACKGROUND AND PURPOSE: Abrupt vessel closure and acute ischemia were unpredictable during percutaneous transluminal coronary angioplasty. Abupt or threatened closure after coronary angioplasty is associated with increased risk of myocardial infarction, emergency coronary artery bypass graft surgery and in-hospital mortality. One of major causes of these complications was associated with coronary artery dissection. Intracoronary stent with various designs have been developed to treat dissections or acute closure after angioplasty. This study reports on the early clinical experience with flexible coil stent in a single center. METHOD: From March 1993 through December 1993, 33 patients underwent coronary stenting with flexible coil stent(12-20mm length, 2.5-3.5mm diameter) for various indications(acute or threatened closure, suboptimal result after balloon angioplasty, elective). RESULTS: Thirty-two flexible coil stent were successfully deployed in 31 patients among 34 attempted stents with 94% of procedural success rate. Intracoronary stenting resulted in an immediate angiographic improvement in the diameter stenosis from 87% before stenting to 18% after stenting by caliper estimation. Emergency coronary artery bypass graft surgery was required in 1 of 33 patients(3%). The incidence of in-hospital myocardial infarction(Q wave and non-Q wave) was 3% (1 of 33 patients.) Complications included blood loss, primarily from the arterial access site in 4 patients, hemopericardium and aspiration pneumonia in 1 patients respectively. CONCLUSION: Initial experience with flexible coil(Gianturco-Roubin) coronary stent indicates that it is a useful adjunct percutaneous intervention to prevent or minimize complications associated with coronary artery dissection after balloon angioplasty with high technical success rate.