MANAGEMENT OF RESTENOSIS WITHIN THE PALMAZ-SCHATZ CORONARY STENT (THE UNITED-STATES MULTICENTER EXPERIENCE)

Coronary stenting was introduced in the hope of improving both the short- and long-term results of conventional balloon angioplasty.1 Nearly 2,000 patients have been treated with the balloon expandable Palmaz-Schatz stent in the United States since 1988, with a 98% acute placement success and minimal residual stenosis.2 Acute closure of the stent has been rare, but subacute thrombotic occlusion has been reported within the first several weeks after stent placement in almost 3% of patients, despite an anticoagulant program including aspirin, dipyridamole and Coumadin™. The incidence of subsequent restenosis varies with the size, location and number of stents placed, but ≥20% of successfully stented patients show angiographic evidence of restenosis 6 months after stent placement.3,4 Despite the well-recognized incidence of in-stent restenosis, however, there have been no formal reports outlining how this type of lesion responds to various management alternatives - in particular to repeat dilatation. © 1993.