Randomised trial of elective stenting after successful percutaneous transluminal coronary angioplasty of occluded coronary arteries

Background The value of angioplasty in occluded coronary arteries is limited by a restenosis/reocclusion rate of 50–70%. In patients with subtotal occlusion, stent implantation has been shown to reduce clinical and angiographic restenosis. Retrospective observational studies have suggested that sten...

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Bibliographic Details
Published in:Heart (British Cardiac Society) 1998-01, Vol.79 (1), p.18-23
Main Authors: Hancock, J, Thomas, M R, Holmberg, S, Wainwright, R J, Jewitt, D E
Format: Article
Language:English
Subjects:
Adult
Aged
Angioplasty
Angioplasty, Balloon, Coronary
Anticoagulants
Biological and medical sciences
Cardiology. Vascular system
Combined Modality Therapy
Coronary Angiography
Coronary Disease - prevention & control
Coronary Disease - surgery
Coronary Disease - therapy
Coronary heart disease
Coronary vessels
Elective Surgical Procedures
Female
Heart
Heart attacks
Humans
intracoronary stenting
left ventricular function
Male
Medical imaging
Medical sciences
Middle Aged
Patients
Recurrence
Stents
total coronary occlusion
Veins & arteries
Ventricular Function, Left
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Summary:Background The value of angioplasty in occluded coronary arteries is limited by a restenosis/reocclusion rate of 50–70%. In patients with subtotal occlusion, stent implantation has been shown to reduce clinical and angiographic restenosis. Retrospective observational studies have suggested that stenting could reduce restenosis in total occlusions. The value of sustained coronary patency on global and regional left ventricular function in this clinical setting has not been defined clearly. Objectives To assess the medium term effect of elective intracoronary stent deployment after successful percutaneous transluminal coronary angioplasty (PTCA) of an occluded coronary artery. Methods Sixty patients with a total coronary occlusion successfully treated by PTCA were randomised to receive an intracoronary stent or no stent. Patients underwent clinical and angiographic follow up at six months. Results Thirty patients received a stent (group A) and 30 were treated by angioplasty alone (group B), all with initial success. One patient in group B required repeat angioplasty with stenting at 24 hours and one patient died after 10 days. Angiographic follow up was available for 57 patients. This showed a significantly reduced reocclusion rate in group A compared with group B (7% v 29%, p 
ISSN:1355-6037
1468-201X
DOI:10.1136/hrt.79.1.18