CORONARY STENTING DECREASES RESTENOSIS IN LESIONS WITH EARLY LOSS IN LUMINAL DIAMETER 24 HOURS AFTER SUCCESSFUL PTCA

Background Early loss of minimal luminal diameter (MLD) after successf ul percutaneous transluminal coronary angioplasty (PTCA) is associated with a higher incidence of late restenosis. Methods and Results Sixty -six patients (66 lesions) with >0.3 mm MLD loss at 24-hour on-line qu antitative coronary angiography were randomized into two groups: 1, Gi anturco-Roubin stent (n=33) and 2, Control, who received medical thera py only (n=33). All lesions were suitable for stenting. Baseline demog raphic, clinical, and angiographic characteristics were similar in the two groups. Restenosis (greater than or equal to 50% stenosis) for th e overall group occurred in 32 of 66 patients (48.4%) at 3.6+/-1-month follow-up angiography. Restenosis was significantly greater in group 2 than in group 1 (75.7% versus 21.2%, P<.001). Vascular complications (21.2% versus 0%) and length of hospital stay (7.3+/-1 versus 2.4+/-0 .5 days, P<.01) were higher for the stent group. Although at follow-up there were no differences in mortality or incidence of acute myocardi al infarction between the two groups, patients in the control group ha d a higher incidence of repeat revascularization procedures (73% versu s 21%, P<.001). Conclusions In patients with successful PTCA but reduc ed luminal diameter demonstrated by repeat angiography at 24 hours, th e Gianturco-Roubin stent appears to reduce angiographic restenosis at follow-up.