CORONARY IMPLANTATION OF SILICONE-CARBIDE-COATED PALMAZ-SCHATZ STENTSIN PATIENTS WITH HIGH-RISK OF STENT THROMBOSIS WITHOUT ORAL ANTICOAGULATION

Coronary stenting in bail-out situations is effective but associated w ith increased stent thrombosis and bleeding rates. Silicone-carbide co ating reduces fibrinogen activation on alloplastic surfaces and thus m ay also reduce stent thromboses. A total of 44 patients received 58 si licone-carbide-coated stents for threatened (80%) or abrupt (20%) clos ure. In addition to heparin, patients were treated with aspirin and ti clopidine (75%) or aspirin (25%) only. Two patients (4.5%) died in the hospital. The combined in-hospital complication rate including death, emergency revascularization, stent-related myocardial infarction, and stent thrombosis was 9% (4 of 44 patients). Major bleeding occurred i n 4 patients (9%). Six-month follow-up angiography was obtained in all eligible patients (42 of 44), revealing a restenosis rate of 21% (9 o f 42). Thus, coronary implantation of silicone-carbide-coated stents i s feasible in bail-out situations without oral anticoagulation and wit h a low complication rate. Further studies are required to optimize th e anticoagulation regimen with this type of coating. (C) 1997 Wiley-Li ss, Inc.