Stent or angioplasty after recanalization of chronic coronary occlusions? (The SARECCO trial)

This study tests whether stent implantation without anticoagulation after c atheter recanalization of coronary occlusions can improve outcome compared with balloon angioplasty alone. One hundred ten patients were randomly assi gned to angioplasty alone (no stent group) or stent implantation (stent gro up) after successful recanalization and balloon angioplasty. The type of st ent and angioplasty technique utilized were decided by the operator. The ac ute procedural success in both groups was 100%, The acute minimal lumen dia meter (MLD) was 1.85 +/- 0.44 mm in the no stent group versus 2.54 +/- 0.53 mm in the stent group (p < 0.01). The diameter stenosis was 21 +/- 13% ver sus 3 +/- 14% (p < 0.01). This was achieved not only by the stent implantat ion itself but primarily by a larger maximum balloon diameter in the stent group after stent implantation (3.32 +/- 0.55 mm vs 2.86 +/- 0.4 mm, p < 0. 05). After 4 months, the MLD wets 1.15 +/- 0.73 mm in the no stent group ve rsus 1.81 +/- 0.9 mm in the stent group (p < 0.01). The diameter stenosis w as 56 +/- 29% versus 34 +/- 28% (p < 0.01). After 2 years, event-free survi val was 26% in the no stent group and 52% in the stent group (p < 0.05). Th us, acute and long-term procedural and angiographic success of stent implan tation without anticoagulation after recanalization of total coronary occlu sions is superior to that of balloon angioplasty alone. This beneficial eff ect is mainly the result of the larger balloon diameters, which may be used after stent implantation. (C) 1999 by Excerpta Medico, Inc.