Balloon angioplasty of ostial left anterior descending coronary artery (LAD) lesions has been associated with a high rate of acute complications and late restenosis. Recently, coronary stenting has been proposed as an effective treatment modality for ostial LAD lesions. To evaluate the effects of stent design on the development of late restenosis, we retrospectively analyzed the efficacy of slotted-tube stent implantation (40 patients, Palmaz-Schatz stent) and coil stent implantation (15 patients, tantalum Cordis stent) of ostial LAD stenosis. Six-month angiographic follow-up data were obtained in 31 patients (82%) with slotted-tube stent implantation and 12 patients (86%) with coil stent implantation. Angiographic restenosis was defined as > or =50% diameter stenosis. The angiographic restenosis rate was significantly lower in slotted-tube stent implantation (32%) than in coil stent implantation (67%) (p<0.05). Target lesion revascularization rate of slotted tube stent implantation was significantly lower (26%) than that of coil stent implantation (57%) (p<0.05). Coil stent implantation of ostial left anterior descending artery lesions was associated with higher late restenosis compared with slotted tube stent implantation. In conclusion, slotted-tube stent implantation might be considered to improve late clinical outcomes of ostial LAD lesions.