Early clinical experience with the implantation of a novel synthetic coronary stent graft

Coating stents with autologous venous grafts has been suggested to prevent problems associated with conventional stenting, but the need for surgical v essel harvest hampered broad application. A novel synthetic coronary stent graft (CSG) overcomes this limitation by a synthetic membrane, fixed betwee n two thin metallic stents. We successfully implanted 21 CSGs in 18 patient s for treatment of acute coronary rupture, thrombus-containing lesions, and lesions with plaque rupture or adjacent pseudoaneurysm. Substantial residu al angiographic diameter stenoses were seen in seven CSGs (25% +/- 10% vs. 8% +/- 6%; P < 0.01), which were implanted with relatively small balloon ca theters (balloon-to-artery ratio 1.00 +/- 0.09 vs. 1.24 +/- 0.18; P = 0.01) and required postdilatation. Overall, the largest balloon catheter applied measured 4.0 +/- 0.7 mm (balloon-to-artery ratio 1.21 +/- 0.20) and the in flation pressure was 16 +/- 3 atm. Final Intravascular ultrasound imaging d emonstrated adequate and symmetrical expansion of the CSG (greater than or equal to 85% +/- 15% of the reference lumen). Elective implantation was ass ociated with two small non-Q-wave myocardial infarctions, resulting from un avoidable occlusions of side branches. Thus, implantation of CSG is feasibl e and safe. Adequate expansion can be achieved by the use of relatively lar ge low-compliant balloon catheters inflated with high pressure. Cathet. Car diovasc. Intervent. 47:496-503, 1999. (C) 1999 Wiley-Liss, Inc.