CLINICAL AND ANGIOGRAPHIC RESULTS OF BALLOON-EXPANDABLE INTRACORONARY STENTS IN RIGHT CORONARY-ARTERY STENOSES

Balloon-expandable stents were placed successfully in 35 (95%) of 37 patients whose right coronary artery lesion was believed to have a poor short- or long-term prognosis with conventional balloon angioplasty because of prior restenosis or adverse lesion morphology. Quantitative angiography showed a reduction in stenosis diameter from 83 ± 14% to 42 ± 14% after conventional balloon dilation, with a further reduction to - 3 ± 12% after stent placement (p < 0.001). There were no acute stent thromboses, but one patient (with two stents and unstented distal disease) developed subacute thrombosis on day 8 after self-discontinuation of warfarin and was treated with thrombolytic therapy and reflation. Follow-up angiography was performed at 4 to 6 months in 25 patients, demonstrating restenosis (83 ± 13%) in 4 (57%) of 7 patients with multiple stents, but only 3 (17%) of 18 patients with a single stent (p < 0.05). Six of the seven in-stent restenotic lesions were subtotal (80 ± 12%) and were subjected to repeat conventional balloon angioplasty (postdilation stenosis 13 ± 21%). The 18 patients without restenosis had a maximal in-stent diameter stenosis of 29 ± 15%, corresponding to a maximal focal neointimal thickness of 0.68 ± 0.26 mm within the stented segment. These preliminary results suggest that the Schatz-Palmaz stent may be a useful adjunctive device in the performance of coronary angioplasty. © 1990.