Y. Ikari et al., LUMINAL LOSS AND SITE OF RESTENOSIS AFTER PALMAZ-SCHATZ CORONARY STENT IMPLANTATION, The American journal of cardiology, 76(3), 1995, pp. 117-120
Restenosis has frequently been observed at the articulation of the Pal
maz-Schatz stent, However, the precise mechanism for this remains poor
ly understood. We measured the luminal diameter in 5 segments within t
he stent in 67 lesions of 63 patients with successful stenting, Lumina
l diameter at all 5 sites was significantly reduced 6 months after ste
nt implantation (3.2 +/- 0.5 vs 2.4 +/- 0.7 mm, p <0.05). Angiographic
restenosis rate was 18%. Restenosis involving the articulation was fo
und in 75% of the lesions, and that involving the articulation or edge
s in 83%, The diameter at the articulation was significantly smaller b
oth immediately (3.0 +/- 0.5 mm vs 3.3 +/- 0.5 mm, p <0.05) and 6 mont
hs after (2.1 +/- 0.8 mm vs 2.5 +/- 0.7 mm, p <0.05) stenting than the
diameter of other stent segments, The loss index was significantly gr
eater at the proximal and distal edges than at the bodies of the stent
(0.98 vs 0.60, p <0.05), The edges of the Palmaz-Schatz stent tend to
dilate more than the body of the stent during normal inflation, Altho
ugh this anchoring system protects against dislodgment or migration of
the stent, it may cause more injury. The articulation has 2 anchoring
edges within only a 1 mm diameter. Thus, restenosis at the articulati
on may be ascribed to residual stenosis, increased intimal proliferati
on due to more severe injury, and delayed late vessel remodeling from
lack of mechanical support. These characteristics may be attributed to
stent design, and design improvement of the articulation may lead to
more favorable results after stent implantation.