INTRACORONARY STENT PLACEMENT WITHOUT COUMADIN OR INTRAVASCULAR ULTRASOUND

Coronary stenting has been associated with the need for intravascular ultrasound, increased anticoagulation, and increased length of stay. W e evaluated the use of ticlopidine and aspirin without ultrasound in 3 22 consecutive patients from February 1995 through January 1996 who un derwent intracoronary stenting with adjunctive high pressure balloon a ngioplasty [mean peak atmospheres (ATM) = 15.9; mean post-dilating bal loon size = 3.4 mm]. Unstable coronary syndrome was the admitting diag nosis in 66% of these patients. Post-stent anticoagulation consisted o f overnight heparin, followed by aspirin (325 mg daily) and ticlopidin e (250 mg twice daily) for 4 to 6 weeks. Among the 322 patients, 575 s tents (Palmaz-Schatz Coronary Stents = 530; Palmaz-Schatz Biliary Sten ts = 33; Gianturco-Roubin Stents = 12) were implanted in 338 coronary vessels (native arteries = 316; saphenous vein grafts = 22). Twenty-th ree patients (7%) had multi-vessel stenting. Average length of stay fo llowing stenting was 1.6 days (average overall hospital length of stay was 2.3 days), and 71% of patients were discharged the next day. Foll ow-up of all 322 patients was performed by telephone contact at least 30 days after discharge. During this period 1 (0.3%) acute thrombosis and no subacute thrombosis occurred. In this series of patients, coron ary stent implantation using routine high pressure balloon post-dilata tion - without intravascular ultrasound - and a combination of aspirin and ticlopidine was performed with no subacute thrombosis and a short length of stay.