STRECKER CORONARY STENT IMPLANTATION - RE SULTS IN 21 CASES

The aim of this study was to assess the safety and efficacy of implant ation of Strecker coronary stents. The implantation was performed in 2 1 patients during elective angioplasty (N = 18) or in emergency situat ions (N = 3). The indications were acute occlusion after angioplasty ( N = 3), restenosis (N = 12), incomplete balloon angioplasty results (N = 4) and implantation of first intent (N = 2). The site of implantati on was a venous bypass graft in 9 cases, the left anterior descending artery in 5 cases, the right coronary artery in 4 cases and the left c ircumflex in 3 cases. The average length of the lesions was 8.4 +/- 4. 1 mm, including 15 short (< 10 mm) and 6 long (> 10 mm) lesions. Four lesions were located at an acute angle (> 45-degrees) and 4 at the sit e of origin of a side branch. The diameter of the normal segment of th e treated artery was < 3 mm in 12 cases and > 3 mm in 9 cases. Seven 3 mm, five 3.5 mm, six 4 mm and three 4.5 mm diameter stents were impla nted. There were no failures to position or implant the stents. After the implantation, the minimal lernen diameter of the artery at the ang ioplasty site was greater than that obtained with balloon (2.87 +/- 0. 67 mm versus 1.83 +/- 1.11 mm, p < 0.001). There was no early restenos is at control angiography at 24 hours (2.78 +/- 0.20 mm versus 2.87 +/ - 0.67 mm NS). At long term (22 +/- 2 months) in the 7 patients who un derwent a control coronary angiogram, 2 had significant restenosis and 1 had an occlusion at the site of angioplasty. Four patients had no s ignificant restenosis. The other patients were asymptomatic. In-hospit al complications were observed in 5 patients. There was one death due to intra-abdominal haermorrhage partly relatedto excessive anticoagula tion. One patient had a large haematoma but did not require surgery. T he other complications were 3 occlusions treated by thrombolysis and r epeat angioplasty (2 patients) and coronary bypass surgery (1 patient) . Strecker stents as easy to implant even in angulated small vessels. The initial success rate is high. The stent restores the normal diamet er of the treated vessel. Implantation is followed by a high incidence of thrombotic and haemorrhagic complications. The long-term results a re satisfactory.