ACUTE CLINICAL AND ANGIOGRAPHIC RESULTS WITH THE NEW AVE MICRO CORONARY STENT IN BAILOUT MANAGEMENT

To determine the feasibility and safety of deployment of this new sten t, we deployed 28 AVE Micro stents in 23 native coronary artery lesion s in 20 patients who developed acute or threatened closure after ballo on angioplasty (BA). Ten stents were deployed in the left anterior des cending artery, 10 in the circumflex, and 8 in the right coronary arte ry, Luminal dimensions were measured using a computer-based quantitati ve coronary angiographic analysis system (CAAS II). Stent deployment w as successful in 27 of 28 attempts (96%). In 1 patient with a threaten ed closure of the left anterior descending artery associated with prox imal vessel tortuosity, attempted stent deployment was unsuccessful. T he clinical course of the other 19 patients in whom stent deployment w as successful was free of coronary reintervention, bypass surgery, and death. A myocardial infarction was observed in 2 patients (10%), in 1 of whom the stent was implanted within 24 hours after the onset of ac ute myocardial infarction, and in the other acute vessel occlusion was present for 58 minutes before stent implantation. No subacute occlusi on was observed. Event-free survival at 30 days after stent implantati on was 85% (17 of 20 patients). Minimal luminal diameter was 0.85 +/- 0.57 mm before and 1.19 +/- 0.66 mm after BA, 2.61 +/- 0.39 mm during balloon inflation, 3.26 +/- 0.46 mm during and 2.74 +/- 0.51 mm after stenting, 3.43 +/- 0.52 mm during balloon inflation after stenting (Sw iss Kiss), and 2.85 +/- 0.48 mm after Swiss Kiss. Average percent diam eter stenosis was reduced from 69% before through 56% after BA to 17% after stenting. During the initial stent implantation, stent recoil wa s 0.52 +/- 0.30 mm (16 +/- 9% of minimal luminal diameter during stent inflation), A Swiss Kiss was performed in 14 stents with an average p ressure of 14 +/- 4 atm, and residual stenosis was reduced from 2.55 m m (21% diameter stenosis) to 2.85 mm (15% diameter stenosis) in these lesions, Angiographic success (<30% residual diameter stenosis) was ac hieved in all stented lesions. The results of this early experience wo uld indicate that the new AVE Micro stent may be deployed with a high procedural success rate and a minimal learning curve. Implantation of the stent for the bailout management of failed BA can be achieved with a low incidence of adverse cardiac events and a high angiographic suc cess rate.