COMPARISON OF RESULTS OF INTRACORONARY IMPLANTATION OF THE PALMAZ-SCHATZ STENT WITH CONVENTIONAL BALLOON ANGIOPLASTY IN CHRONIC TOTAL CORONARY ARTERIAL-OCCLUSION

We compared angiographic and clinical outcomes after successful revasc ularization of chronic total coronary arterial occlusion with the plac ement of the Palmaz-Schatz stent (43 patients) and conventional balloo n angioplasty (53 patients). After the procedure, the coronary stent l ed to a greater minimal lumen diameter than conventional balloon angio plasty (2.6 vs 1.7 mm, p < 0.001), resulting in a smeller residual ste nosis (6.5% vs 36.7%, p < 0.001). At 6-month follow-up, there was no s ignificant difference in late loss between the groups, resulting in a larger minimal lumen diameter at follow-up in the stent group (1.8 vs 1.1 mm, p < 0.001). The incidence of restenosis was lower in the stent group (27.9% vs 56.6%, p < 0.005). The frequency of the combination o f myocardial infarction and coronary artery bypass graft surgery tende d to be less in the stent group (2.3% vs 11.3%, p = 0.09). Placement o f the Palmaz-Schatz stent improved left ventricular ejection fraction by 26% in patients who had reduced left ventricular function (p < 0.05 ), but conventional balloon angioplasty did not. Thus, placement of th e Palmaz-Schatz stent provided a wider lumen than did conventional bal loon angioplasty and, therefore, reduced the incidence of restenosis i n chronic total coronary arterial occlusion. The lower restenosis rate of coronary stenting would be beneficial for long-term clinical outco me in patients with chronic total occlusion. (C) 1996 by Excerpta Medi ca, Inc.