ELECTIVE IMPLANTATION OF INTRACORONARY STENTS WITHOUT INTRAVASCULAR ULTRASOUND GUIDANCE OR SUBSEQUENT WARFARIN

Two hundred forty-three stents (203 Palmaz-Schatz, 40 Gianturco-Roubin ) were electively implanted in 188 lesions in 168 patients (mean age 5 8 +/- 10 years, 77% males) using angiographic but not ultrasound guida nce. Patients were treated subsequently with aspirin and observed in h ospital for up to 7 days. Those with acute myocardial infarction, radi olucent defects in coronary arteries suggestive of thrombus, and resul ts that were not optimal after stent implantation were anticoagulated with warfarin and not included in the study. Two had subacute stent th rombosis and two patients non-Q-wave myocardial infarction in-hospital . At follow-up,(median 149 days) none had had subacute stent thrombosi s, one suffered non-Q-wave myocardial infarction, none had died, and n one had developed major complications at the vascular access site. Fou rteen (8%) had undergone further revascularisation procedures. This in itial experience suggests that aspirin is sufficient to prevent subacu te stent thrombosis after elective high pressure assisted coronary ste nt implantation without intravascular ultrasound guidance if the angio graphic appearance after stent deployment is optimal. (C) 1996 Wiley-L iss, Inc.