THE NEW ACS MULTILINK CORONARY STENT - SINGLE-CENTER EXPERIENCE IN 103 CONSECUTIVE PATIENTS WITH AND WITHOUT ORAL ANTICOAGULATION

Background: Since the introduction of this stent, anticoagulant regime ns have changed front an aggressive protocol (aspirin, heparin, and wa rfarin) to a simplified regimen (aspirin and ticlopidine). In this stu dy our experience with this stent is reviewed, and acute and chronic o utcomes with the two anticoagulant protocols are compared All patients undergoing ACS Multilink stent implantation between July 1993 and Jun e 1996 were included The clinical and angiographic characteristics wer e documented and outcomes recorded. The two anticoagulant groups were compared: 103 patients (94 males, age range 41-80) years, mean 59) rec eived 124 stents; 68% had Canadian Cardiac Society (CCS) grade III or IV angina prior to the procedure; and 73% underwent bail-out stenting. High pressure inflations (> 14 a) were used in 40% of cases. Eighty-f our (85%) received aspirin and ticlopidine only. The initial success r ate was 99%. Two patients underwent emergency surgery. There were no d eaths and no cases of subacute stent thrombosis. Clinical follow-up is available on 66 patients (mean 190 days). Of these, 56 patients (54%) are in CCS grade 0 or I. One patient has required surgical revascular ization. There is one case of documented restenosis within the stented segment. Conclusion: The ACS Multilink stent can be safely deployed i n elective and bail-out situations with a subacute thrombosis rate tha t compares favorably with other stents. The clinical and angiographic restenosis rate is also very low. Optimal results can be achieved with out the routine use of either intracoronary ultrasound or high pressur e, postdeployment balloon inflations and without oral anticoagulation.