ELECTIVE CORONARY IMPLANTATION OF A NEW S TENT WITHOUT CONVENTIONAL ANTICOAGULATION

Objective: To assess in an open prospective study the angiographic and clinical results of the elective implantation of the recently develop ed AVE micro-stent (Applied Vascular Engineering, Santa Rosa, CA, USA) , in combination with dual antiaggregation treatment. Patients and met hods: Between January and December 1995 AVE micro-stents were implante d into 128 vessels in 121 patients (20 women, 101 men; mean age 60.7 /- 9.5 [34-84] years) with symptomatic coronary heart disease (CHD). I ndication for the primary implantation of the stent type was a complex morphology of the stenosis with unfavourable short- and long-term pro gnosis. The stent consists of a 4 mm long tubular highly flexible segm ent made of 0.008 inch wire and can be advanced even into tortuous ves sels. After balloon dilatation of the stenosis the stent was advanced into the vessel wall at a pressure of 10-12 bar, followed by further d ilatation at 16-18 bar. Conventional long-term anticoagulation was dis pensed with, patients only receiving antiaggregation medication: 500 m g ticlopidine and 100 mg aspirin daily for 6 weeks. Results: The prima ry success rate of stent implantation was 99 % (121 of 122). Neither a cute nor subacute thromboses were revealed during hospital stay nor wa s there any emergency bypass operation or early repeat balloon angiopl asty. There were no abnormal bleedings. Conclusion: Stenoses which are unsuitable for conventional balloon angioplasty can be reliably treat ed with the AVE microstent. Optimal high-pressure dilatation in combin ation with dual antiaggregation treatment will prevent stent thrombosi s and bleeding complications.