PATENCY OF INTERMEDIATE SIZE SIDE BRANCHES AFTER PALMAZ-SCHATZ STENT IMPLANTATION

Tile immediate and long-term patency of intermediate size side branche s was assessed by serial coronary angiography in 47 patients with 48 l esions to determine whether the presence of these side branches (1-2 m m in diameter) is unsuitable for Palmaz-Schatz stent implantation. Cor onary angiography was performed at baseline, after conventional balloo n angioplasty, immediately after stent implantation, at 1 week, and at 6-month follow-up. Sixty-eight lesion-associated side branches that w ere 1-2 mm in diameter, 11 with branch ostial stenosis (Group A) and 5 7 without ostial stenosis (Group B) were studied. After stent implanta tion, 9 (13%) branches became totally occluded and coronary flow deter iorated in 13 branches (19%), The incidence of side branch occlusion d uring the procedure in group A was greater than in group B (55% vs. 12 %; p < 0.005), One (2%) patient suffered persistent chest pain, but no procedure was complicated by Q-wave myocardial infarction or signific ant elevation of creatine kinase concentration, Flow improved in 82% o f the occluded side branches after 1 week and in 90% after 6 months. T hese results suggest that the presence of intermediate size side branc hes is not a contra-indication to Palmaz-Schatz stent implantation.