Stent placement to prevent restenosis after angioplasty in small coronary arteries

被引:83
作者
Doucet, S
Schalij, MJ
Vrolix, MCM
Hilton, D
Chenu, P
de Bruyne, B
Udayachalerm, W
Seth, A
Bilodeau, L
Reiber, JHC
Harel, F
Lespérance, J
机构
[1] Montreal Heart Inst, Dept Med, Montreal, PQ H1T 1C8, Canada
[2] Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands
[3] Ziekenhuis Oost Limburg, Genk, Belgium
[4] Royal Jubilee Hosp, Victoria, BC, Canada
[5] Catholic Univ Louvain, Mt Godinne Hosp, Mont Godinne, Belgium
[6] Ctr Cardiovasc, Aalst, Belgium
[7] Chulalongkorn Univ, Bangkok, Thailand
[8] Escorts Heart Inst & Res Ctr, New Delhi, India
[9] Heart Core BV, Leiden, Netherlands
关键词
angioplasty; stents; restenosis;
D O I
10.1161/circ.104.17.2029
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Lesions in small-diameter vessels (<3 mm) define a group with distinct clinical and morphological characteristics. There is an inverse relationship between vessel size and angiographic restenosis rate. This study assessed whether stents reduce angiographic restenosis in small coronary arteries compared with standard balloon angioplasty. Methods and Results-We randomly assigned 351 symptomatic patients needing dilatation of I native coronary vessel between 2.3 and 2.9 mm in size to angioplasty alone (n=182) or stent implantation (n=169). The primary end point was angiographic restenosis at 6 months. Secondary end points included death, myocardial infarction, bypass surgery, and target vessel revascularization in hospital and at 6 months. There were no significant differences between groups in terms of major in-hospital complications. There was a trend toward fewer in-hospital events in the stent group (3% versus 7.1% in angioplasty group, P=0.076). Crossovers to stent occurred in 37 patients (20.3%). Repeat angiography at 6-month follow-up was performed in 85.3% of patients. Angiographic restenosis occurred in 28% of the stent group and 32.9% of the angioplasty group (P=0.36). Target vessel revascularization was required in 17.8% versus 20.3% of patients (P=0.54), respectively. Conclusions-Stenting and standard coronary angioplasty are associated with equal restenosis rate in small coronary arteries. With a lower in-hospital complication rate, stenting may be a superior strategy in small vessels.
引用
收藏
页码:2029 / 2033
页数:5
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