CORONARY STENTING DECREASES RESTENOSIS IN LESIONS WITH EARLY LOSS IN LUMINAL DIAMETER 24 HOURS AFTER SUCCESSFUL PTCA

Background Early loss of minimal luminal diameter (MLD) after successful percutaneous transluminal coronary angioplasty (PTCA) is associated with a higher incidence of late restenosis. Methods and Results Sixty-six patients (66 lesions) with >0.3 mm MLD loss at 24-hour on-line quantitative coronary angiography were randomized into two groups: 1, Gianturco-Roubin stent (n=33) and 2, Control, who received medical therapy only (n=33). All lesions were suitable for stenting. Baseline demographic, clinical, and angiographic characteristics were similar in the two groups. Restenosis (greater than or equal to 50% stenosis) for the overall group occurred in 32 of 66 patients (48.4%) at 3.6+/-1-month follow-up angiography. Restenosis was significantly greater in group 2 than in group 1 (75.7% versus 21.2%, P<.001). Vascular complications (21.2% versus 0%) and length of hospital stay (7.3+/-1 versus 2.4+/-0.5 days, P<.01) were higher for the stent group. Although at follow-up there were no differences in mortality or incidence of acute myocardial infarction between the two groups, patients in the control group had a higher incidence of repeat revascularization procedures (73% versus 21%, P<.001). Conclusions In patients with successful PTCA but reduced luminal diameter demonstrated by repeat angiography at 24 hours, the Gianturco-Roubin stent appears to reduce angiographic restenosis at follow-up.