Angiographic restenosis after successful wallstent stent implantation: An analysis of resk predictors

Lau, Kean‐Wah; Gunnes, Paul; Williams, Miles; Rickards, Anthony F.; Sigwart, Ulrich

doi:10.1016/0002-8703(92)90059-5

Cited by 10 publications

(8 citation statements)

References 43 publications

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“…The restenosis rate in our patient cohort was comparable to recently published studies [5,27,28]. However, this rate can be considered surprisingly low, since we had included a high proportion of high-risk patients with unstable angina in 30% of the WS patients and 24% in the PS group and a high proportion of restenotic lesions.…”

Section: Angiographic Datasupporting

confidence: 86%

“…There was a preselection bias in our study, with a higher incidence of right coronary artery location (53% vs. 12%) in the WS group and a high reference diameter of the target vessel in both stent groups, which are found to be negative predictors for restenosis [27][28][29]. The angiographic measurements revealed a strong correlation between stent-to-artery ratio and relative loss.…”

Section: Angiographic Datamentioning

confidence: 91%

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Stent design‐related coronary artery remodeling and patterns of neointima formation following self‐expanding and balloon‐expandable stent implantation

König¹,

Schiele²,

Rieber³

et al. 2002

Cathet Cardio Intervent

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The self-expanding Wallstent (WS) and balloon-expandable Palmaz-Schatz stents (PS) display different mechanical and dynamical stent properties. We analyzed the impact of the respective stent design on coronary wall geometry using quantitative coronary angiography (QCA) and intracoronary ultrasound (ICUS) measurements. Serial measurements were performed within the stent and within reference segments of 50 patients (25 WS, 25 PS). Relative changes for each parameter in both stent designs were calculated (Mann-Whitney U-test; 95% CI). The luminal net gain in WS was not significantly higher in WS compared with PS (1.63 +/- 1.11 vs. 1.44 +/- 0.63 mm; P = 0.2554). The respective loss indexes were also similar (0.38 +/- 0.42 vs. 0.36 +/- 0.23; P = 0.8578). The WS segments showed significant postinterventional stent expansion with positive vessel remodeling. The neointima formation was significantly higher in WS segments (4.23 +/- 2.07 vs. 2.22 +/- 2.22 mm(2)). The coronary wall morphology and stent geometry after 6.5 +/- 1.2 months are related to the stent design. In WS segments, the neointima formation was balanced by postinterventional stent expansion, resulting in a comparable relative lumen loss in both stent types. The respective stent design had no impact on the vessel reference segments.

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Section: Angiographic Datasupporting

confidence: 86%

Section: Angiographic Datamentioning

confidence: 91%

Stent design‐related coronary artery remodeling and patterns of neointima formation following self‐expanding and balloon‐expandable stent implantation

König¹,

Schiele²,

Rieber³

et al. 2002

Cathet Cardio Intervent

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“…Comparing the outcome to balloon angioplasty of long lesions reported in previous studies, the clinical success rate was significantly better [1,2]. The late clinical outcome was promising with an event-free survival of 76% which is comparable to the results obtained with the self-expandable Wallstent [22,23].…”

Section: Early and Late Outcomesupporting

confidence: 62%

“…Likewise, the balloon used for postdilatation can be positioned inside the stent to protect against dissections at the stent margins [7,8]. The clinical success rate is equal to or better than reported with other types of stents [15,[21][22][23] and only slightly lower than after stent implantations in shorter segments [5][6][7][8]. However, the extensive experience of the operators with all different Micro Stents (Ͼ700 implants until now, Ͼ200 implants during the study period) may have contributed to this favorable outcome [7,8].…”

Section: Early and Late Outcomementioning

confidence: 94%

Stenting of long coronary artery lesions: Initial angiographic results and 6-month clinical outcome of the micro stent II-XL

Schalij

Udayachalerm

Oemrawsingh

et al. 1999

Cathet. Cardiovasc. Intervent.

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To evaluate the results of long Micro Stent II (MS‐XL) implantations, 119 MS‐XLs were implanted in 102 patients (age, 62.83 years). Nineteen stents (16%) were implanted in saphenous vein grafts; 100 stents (84%) were implanted in native coronary arteries. Twenty‐five patients (25%) were treated because of acute myocardial infarction (AMI); 30 patients (29%) because of unstable angina or angina class IV, and 47 patients (46%) because of stable angina. Eighty‐six de novo lesions (84%) and 16 restenotic lesions (16%) were treated. Indications for stent implantation include elective, 61 patients (60%); suboptimal balloon angioplasty result, 22 patients (21%); and bailout after balloon angioplasty, 19 patients (19%). Because of residual thrombus after stenting, 27 patients (26%) received abciximab. All patients received ticlopidin for 28 days and acetylsalicylic acid. One hundred and seventeen MS‐XLs (98%) were implanted successfully. Additional (shorter) MS‐II were implanted in 40 patients (39%). The stented segment length was 45 ± 20 mm. The minimum lumen diameter increased from 0.5 ± 0.5 mm before to 2.7 ± 0.5 mm after stent implantation. The acute gain was 2.2 ± 0.4 mm. Early clinical events (<4 weeks) include death, 3 (3%); subacute stent thrombosis, 1 (1%); non–Q‐wave infarction, 2 (2%); CABG, 1 (1%); vascular complications, 2 (2%). Late clinical events (<6 months) include acute myocardial infarction, 5 (5%); reintervention, 6 (6%); CABG, 1 (1%). The procedural success rate was 88%, and the event free survival at 6 months was 76%. Stenting of long lesions with the MS‐XL was successful and associated with an acceptable complication rate. Cathet. Cardiovasc. Intervent. 48:105–112, 1999. © 1999 Wiley‐Liss, Inc.

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“…Lengths of stent up to 49 mm and diameters up to 5 mm are now available, allowing complete coverage of long lesions with the minimum number of stents. Intravascular ultrasound has clarified the role of oversizing and highpressure balloon inflations postdeployment in ensuring complete apposition of the stent with the vessel wall [11][12][13], with an associated reduction in acute stent thrombosis. This has occurred in parallel with the transition from the use of an aggressive anticoagulation regimen [3,9] to one that is focused on preventing platelet aggregation [14,15].…”

Section: Introductionmentioning

confidence: 99%

Angiographic and clinical restenosis following the use of long coronary wallstents

Williams

Thomas

Robinson

et al. 1999

Cathet. Cardiovasc. Intervent.

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Angiographic restenosis after successful wallstent stent implantation: An analysis of resk predictors

Cited by 10 publications

References 43 publications

Stent design‐related coronary artery remodeling and patterns of neointima formation following self‐expanding and balloon‐expandable stent implantation

Stent design‐related coronary artery remodeling and patterns of neointima formation following self‐expanding and balloon‐expandable stent implantation

Stenting of long coronary artery lesions: Initial angiographic results and 6-month clinical outcome of the micro stent II-XL

Angiographic and clinical restenosis following the use of long coronary wallstents

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