BAILOUT CORONARY STENTING WITHOUT ANTICOAGULATION OR INTRAVASCULAR ULTRASOUND GUIDANCE - ACUTE AND 6-MONTH ANGIOGRAPHIC RESULTS IN A SERIESOF 120 CONSECUTIVE PATIENTS

The purpose of this study was to evaluate the feasibility, safety, and efficacy of bailout coronary stenting without anticoagulation or intr avascular ultrasound guidance in patients with acute or unequivocal th reatened closure after conventional angioplasty. One hundred twenty co nsecutive patients were prospectively enrolled according to the follow ing criteria: 1) acute or threatened closure after balloon angioplasty ; 2) reference vessel diameter greater than or equal to 2.5 mm. All pa tients after stent implantation were on antiplatelet treatment with as pirin and ticlopidine. Four types of stents were used: Palmaz-Schatz ( J&J), Gianturco-Roubin (Cook), Freedom (Global Therapeutics), and Micr ostent (AVE). Procedural results: a total of 206 stents were implanted in 134 target lesions with a stent deployment success rate of 100%; 4 4 target lesions were treated with multiple stent implantation; the me an luminal diameter after stenting was 3.14 +/- 0.34 mm, and the mean final percent diameter stenosis was -2 +/- 10%; the mean balloon to ve ssel ratio was 1.11 +/- 0.15; the mean final pressure inflation was 13 .9 +/- 2.4 atm; an optimal angiographic result was achieved in 128 les ions (96%). In-hospital results: in-hospital recurrent ischemia occurr ed in 4 patients (3%); recurrent ischemia resulted directly in death i n 1 patient, in nonfatal Q-waves infarction in 2 patients, and in emer gency coronary artery surgery in 1 patient. Six-month clinical follow- up results: event free survival rate was 77%; 1 patient had non fatal infarction; the incidence of repeat revascularization procedures was 1 9%; there were no cardiac deaths. Angiographic follow-up results (foll ow-up rate 93%): the restenosis or reocclusion rate was 28%. Bailout c oronary stenting without chronic anticoagulation treatment or intravas cular ultrasound guidance may be considered a highly feasible and safe treatment for acute or threatened closure after failed angioplasty. ( C) 1997 Wiley-Liss, Inc.