INTRACORONARY STENTING USING SLOTTED TUBULAR STENTS WITHOUT INTRAVASCULAR ULTRASOUND AND ANTICOAGULATION

Intravascular ultrasound guidance has been suggested as a prerequisite before managing patients receiving slotted tubular stents without ant icoagulation. The purpose of this prospective observational study was to determine if patients receiving this stent can be similarly managed following angiographic guided stent deployment without intravascular ultrasound assistance. A total of 137 patients receiving slotted tubul ar stents were selected to receive a protocol of aspirin 325 mg and ti clopidine 250 mg for 30 days following the satisfaction of certain ang iographic criteria. These criteria were: adequate coverage of intimal dissections, absence of residual filling defects, and normal (TIMI III ) flow in the stented vessel at the end of the procedure. The stenting procedure was planned in 68% of patients end unplanned in 32% of pati ents. During the 30 day clinical follow period there were no stent thr ombosis events, no Q-wave myocardial infarctions, and no deaths. Non-Q -wave myocardial infarction occurred in 3 patients (2.2%), hemorrhage requiring blood transfusion in 3 patients (2.2%), and 1 patient (0.7%) developed a pseudo-aneurysm of the cannulated femoral artery. These d ata indicate that patients receiving slotted tubular stents with optim al angiographic results can be safely managed with the combination of aspirin and ticlopidine without anticoagulation or the need for intrav ascular ultrasound guidance. (C) 1996 Wiley-Liss, Inc.