Immediate and Follow-up Results of Stenting for the Small Coronary Artery Disease

ABSTRACT

BACKGROUND: Intracoronary stenting in large coronary artery with diameters >3 mm has been shown to be beneficial in the treatment of acute or threatened closures complicating balloon angioplasty and in the prevention of restenosis. However, whether equally favorable results are afforded by stent placement in small vessels (<3 mm) remains unclear. Accordingly, we evaluated the safety and feasibility of intracoronary stenting in native coronary vessels less than 2.75 mm in size. METHODS: Between January 1997 and July 1998, seventy eight patients with 81 lesions were treated with 83 stents, regardless of clinical setting. The angiographic criteria for enrollment included at least 70% stenosis and a vessel that reference diameter was less than 2.75 mm. Every patients received aspirin (300 mg qd, indefinitely) and ticlopidine (250 mg bid, one month) and was given a bolus dose of 10,000 U heparin during procedure. RESULTS: Angiographic success was achieved in 80 of 81 attempts (98%). There was one in-hospital death because of pump failure in AMI patient. There was no acute stent thrombosis. At 6 month follow-up, event free survival was achieved in 90% of patients and angiographic restenosis was found in 28% of patients (9/32). CONCLUSION: The present observational study demonstrates that angiography-guided stent placement in coronary artery < 2.75 mm in diameter is safe and effective in conjunction with current stent deplyment technique and antiplatelet protocol.