Clinical Experience with the Palmaz-Schatz Coronary Stent: Initial Results and 7 Month Follow-up

ABSTRACT

BACKGROUND: Although percutaneous transluminal coronary angioplasty(PTCA), first reported in 1977, represents a major advance in cardiovascular therapeutics, acute closure and restenosis are major limitations of PTCA. The focus of this report is to describe the procedural results and short-term follow-up obtained at Yonsei Cardiovascular center. METHODS: We implanted 12 balloon expandable Palmaz-Schatz stents in 12 patients with significant stenosis of coronary artery. Five patients presented as candidates for primary stenting and the remainder presented with restenosis. Clinically, there were unstable angina in 4, stable angina in 5, old myocardial infarction with stable angina in 2, and old myocardial infarction in 1. The stented vessels were the right coronary artery in 4 and left anterior descending artery in 8. All patients received a single stent. The sizes of stents were 3.0mm in 9, 3.5mm in 2, and 4mm in 1. The lesion morphology according to AHA/ACC classification were type A in 1, type B in 10, and type C in 1. The extent of coronary artery disease was 1-vessel in 4, 2-vessel in 6 and 3-vessel in 2. RESULTS: Successful delivery was accomplished in all patients and complications including acute and subacute thrombosis bleeding requiring transfusion, myocardial infarction, and death were absent. Vessel patency after mean follow-up of 7 month showed restenosis in 4 out of 7 patients 50% in 1, 60% in 1., 0% in 1 and total obstruction in 1 patient. PTCA was done in the patient with 80% restenosis successfully. CONCLUSION: Balloon-expandable intracoronary stenting is a feasible method for treating the acute complication of balloon angioplasty. It seemed to reduce the rate of restenosis for single stent implantation, but long-term results and indications should be evaluated more extensively.