EARLY CLINICAL-EXPERIENCE WITH THE MULTILINK CORONARY STENT

The Multi-Link coronary stent (Advanced Cardiovascular Systems, Santa Clara, CA) is a balloon expandable stent carved from a stainless steel cylinder and is composed of 12 corrugated rings connected by multiple links. This design gives the stent great flexibility and conformity a s well as radial strength. For the 3 month period from November 1995 t o January 1996, all patients undergoing stent implantation in our inst itution were treated with this device, except for vessels smaller than 2.7 mm or larger than 3.7 mm in diameter, left main disease, or those who could not tolerate anticoagulation therapy. Forty patients, with a total of 42 arteries or 44 lesions, were treated with 56 stents, or 1.33 stents per artery. Clinical presentaton included stable angina in 13 (32.5%), unstable angina in 24 (60%), acute myocardial infarction in 2 (5%), of whom 1 was in cardiogenic shock, and atypical symptoms w ith an abnormal thallium stress test in 1 (2.5%). According to the Ame rican College of Cardiology/American Heart Association (ACC/AHA) class ification, 8 lesions (18%) were type A, 14 (32%) type B1, 11 (25%) typ e B2, and 11 (25%) type C. Forty-three lesions (97.7%) were de novo an d 1 (2.3%) restenotic. Stent delivery was successful in all patients. Complications included 1 balloon rupture at 7 atm but without sequelae , and 2 patients in whom the coronary guide wire became kinked and loc ked inside the catheter shaft of the stent delivery system but stent d elivery was eventually successful. Mean diameter stenosis was reduced from 76 +/- 13% prestenting to 2 +/- 9% poststenting and minimal lumen diameter increased from 0.87 +/- 0.38 to 2.82 +/- 0.34 mm. There were no acute-subacute stent thromboses, bleeding/vascular complications, or major cardiac events such as myocardial infarction, coronary artery bypass surgery, or death during a follow-up period of 2-5 months (mea n 3.6 months). In conclusion, our early clinical experience with the M ulti-Link stent is very encouraging, with a very high rate of successf ul delivery and minimal complications. (C) 1996 Wiley-Liss, Inc.