Complications and follow-up after intracoronary stenting: critical analysis of a 6-year single-center experience

Am Heart J. 1994 Feb;127(2):262-72. doi: 10.1016/0002-8703(94)90112-0.

Abstract

From April 1986 through April 1992, 123 patients received 153 intracoronary stents (131 Medinvent, 13 Palmaz-Schatz, 9 Wiktor) during 131 procedures. The indication was bail-out treatment in 39, restenosis in 59 native coronary arteries, and stenosis or restenosis in 33 vein grafts. Stent-related events were studied during the in-hospital stay and on follow-up and included closure, stent restenosis, myocardial infarction, death, and the need for coronary bypass surgery. A Kaplan-Meier estimate extended to 6 years showed different short- and long-term outcomes for the distinct treatment groups (p < 0.05): right coronary artery stenting (more particularly, stenting for restenosis after angioplasty) had the lowest and vein graft stenting had the highest stent-related complication rate. The complication rate was similar (p > 0.25) (1) in the case of multiple nontandem stent implantation during the same procedure; (2) for the different endoprosthesis sizes; and (3) during the different procedural years. In native coronary arteries, restenosis after angioplasty of the right coronary artery could be a preferential indication for coronary artery stenting. Despite a favorable short-term outcome, vein graft stenting has a high incidence of events on long-term follow-up, mainly because of late restenosis. Multiple nontandem stenting during the same procedure is not associated with a higher incidence of complications, in particular, the restenosis rate is not appreciably higher. Finally, only a minor benefit for the learning curve is apparent from this single-center experience with continual unchanged postprocedural management.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angina Pectoris / etiology
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Coronary Artery Bypass
  • Coronary Disease / surgery
  • Coronary Disease / therapy*
  • Coronary Thrombosis / etiology
  • Coronary Vessels / pathology*
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology
  • Recurrence
  • Saphenous Vein / pathology
  • Saphenous Vein / transplantation
  • Stents / adverse effects*