INTRACORONARY STENTING IN THE TREATMENT OF ACUTE OR THREATENED CLOSURE IN ANGIOGRAPHICALLY SMALL CORONARY-ARTERIES (LESS-THAN-3.0-MM) COMPLICATING PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

The effect of the Flex-Stent (R) on immediate and longterm angiographi c and clinical results for acute and threatened closure was evaluated in 42 consecutive patients with coronary arterial segments <3.0 mm in diameter after percutaneous transluminal coronary angioplasty (PTCA), Forty-two consecutive patients were treated with Flex-Stent (2.0 or 2. 5 mm) for acute or threatened closure complicating PTCA. Ten patients (24%) had acute closure and 32 (76%) had threatened closure with a res idual luminal stenosis of >50%. Successful stent deployment was achiev ed in 40 patients (95%) with a primary clinical success rate of 90% (f reedom from myocardial infarction, coronary artery surgery, and death) . In-hospital complications occurred in patients (some patients fell i nto more than one category): 3 (7.1%) had coronary bypass surgery, 1 ( 2.4%) had acute stent thrombosis, 1 (2.4%) had subacute stent thrombos is, 2 (4.8%) had myocardial infarction, and 1 (2.4%) had dextran aller gy, There was no hospital death. Clinical follow-up was complete at a mean of 14.8 +/- 7.6 months, and recurrence of angina was noted in 20 of 38 eligible patients (53%). Angiographic restenosis was found in 19 of 29 patients (66%) (76.3% of eligible patients) on follow-up angiog raphy (mean 5.9 +/- 4.6 months). Fourteen patients (74%) underwent suc cessful repeat PTCA at the stented site, 4 of 38 patients (11%) had by pass surgery. Intracoronary stenting in the treatment of acute or thre atened closure in arteries <3.0 mm is effective in improving the acute clinical outcome and is a viable nonsurgical alternative for this sub set of patients.