Comparison of direct coronary stenting with and without balloon predilatation in patients with stable angina pectoris

被引：51

作者：

Carrié, D ^{[1
]}

Khalifé, K ^{[1
]}

Citron, B ^{[1
]}

Izaaz, K ^{[1
]}

Hamon, M ^{[1
]}

Juiliard, JM ^{[1
]}

Leclercq, F ^{[1
]}

Fourcade, J ^{[1
]}

Lipiecki, J ^{[1
]}

Sabatier, R ^{[1
]}

Boulet, V ^{[1
]}

Rinaldi, JP ^{[1
]}

Mourali, J ^{[1
]}

Sabatier, R ^{[1
]}

Boulet, V ^{[1
]}

Rinaldi, JP ^{[1
]}

Mourali, S ^{[1
]}

Fatouch, M ^{[1
]}

El Mokhtar, E ^{[1
]}

Aboujaoudé, F ^{[1
]}

Elbaz, M ^{[1
]}

Grolleau, R ^{[1
]}

Steg, PG ^{[1
]}

Puel, J ^{[1
]}

机构：

[1] Hop Purpan, Dept Cardiol, F-31059 Toulouse, France

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2001年 / 87卷 / 06期

关键词：

D O I：

10.1016/S0002-9149(00)01485-5

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The purpose of this study was to compare the effects of stent placement with and without balloon predilatation on duration of the procedure, reduction of procedure-related costs, and clinical outcomes. Although preliminary trials of direct coronary stenting have demonstrated promising results, the lack of randomized studies with long-term follow-up has limited the critical evaluation of the role of direct stenting in the treatment of obstructive coronary artery disease. Between January and September 1999, 338 patients were randomly assigned to either direct stent implantation (DS+; 173 patients) or standard stent implantation with balloon predilatation (DS-; 165 patients). Baseline clinical and angiographic characteristics were similar in the 2 groups. Procedural success was achieved in 98.3% of patients assigned to DSS and 97.5% of patients assigned to DS- (p = NS), with a crossover rate of 13.9%. Compared with DS-, DSS conferred a dramatic reduction in procedure-related cost ($956.4 +/- $352.2 vs $1,164.6 +/- $383.9, p <0.0001) and duration of the procedure (424.2 +/- 412.1 vs 634.5 +/- 390.1 seconds, p <0.0001). At 6-month follow-up, the incidence of major adverse cardiac events including death, angina pectoris, myocardial infarction, congestive heart failure, repeat angioplasty, or coronary artery bypass graft surgery was 5.3% in DS+ and 11.4% in DS- (p = NS). Multivariate analysis demonstrated that major adverse cardiac events rates were related to stent length of 10 mm (relative risk [RR] 3.25, 95% confidence intervals [CI] 1.36 to 7.78; p = 0.008), stent diameter of 3 mm (RR 2.69, 95% CI 1.03 to 7.06; p = 0.043), and complex lesion type C (RR 2.83, 95% CI 1.02 to 7.85; p = 0.045). Thus, in selected patients, this prospective randomized study shows the feasibility of DS+ with reduction in procedural cost and length, and without an increase in in-hospital clinical events and major adverse cardiac events at 6-month follow-up. (C) 2001 by Excerpta Medica, Inc.

引用

页码：693 / 698

页数：6

共 25 条

[1] CORONARY RESTENOSIS - EVALUATION OF A RESTENOSIS INJURY INDEX IN A SWINE MODEL [J].