"Late Clinical Outcomes of Cordis Tantalum Coronary Stenting without Anticoagulation : Validation of Angiographic Measurement and In-stent Restenosis by Intravascular Ultrasound"

ABSTRACT

BACKGROUND: The Cordis coronary stent is a flexible, balloon expandable, radiopaque tantalum stent. Previous reports have shown excellent initial clinical outcomes. To our knowledge, there is no report of the long-term clinical outcomes. The intensely radiopaque tantalum may interfere with the angiographic assessment. We intended to evaluate long-term clinical and angiographic restenosis rates after successful implantation of the Cordis tantalum coronary stent. METHOD: Two hundred and eighty-five consecutive patients with 300 lesions were treated with 366 Cordis stents. An angiographic follow-up substudy was performed in 190 lesions ; 6 month follow-up angiograms were available in 167(88%). At follow-up, intravascular ultrasound(IVUS) was performed to (1) determine the pattern of restenosis and (2) to validate the quantitative coronary angiographic(QCA) caliper measurements. RESULTS: IVUS and QCA caliper measurement of minimal luminal diameter correlated reliably (r=0.767, p<0.001). The QCA analysis detected diffuse in-stent restenosis more reliably than focal in-stent restenosis(p<0.01). The overall angiographic restenosis rate was 19%, The factors affecting angiographic restenosis were post-stent minimum lumen diameter, type C lesion, and reference vessel size. CONCLUSION: We concluded 1) The angiographic restenosis rate of Cordis stent was comparable to that of other slotted-tube stent. 2) The QCA caliper method is reliable for the assessment of Cordis in-stent restenosis, especially in the detection of diffuse in-stent restenosis. However, QCA may miss focal in-stent restenosis only detectable by IVUS