Pv. Oemrawsingh et al., Clinical and angiographic outcome of stent implantation without predilatation using the Jostent Flex stent, J INVAS CAR, 12(4), 2000, pp. 187-193
Conventional stenting requires predilatation, which potentially increases v
essel wall injury and cost of the procedure. In this study, the safety and
efficacy of direct Jostent Flex(R) (Jomed AB, Helsingborg, Sweden) stent pl
acement was evaluated in 50 patients. Quantitative coronary angiography was
performed at baseline, post-stent and 6 months follow-up. Clinical follow-
up was done up to 9 months. In 50 patients (38 male/12 female; age 61 +/- 1
2 years), with stable (n = 42; 84%) or unstable (n = 8; 16%) angina, 53 Jos
tent Flex (JF) stents (diameter 3.2 +/- 0.2 mm) were implanted for 51 steno
ses. Direct stenting was successful in 46 stenoses (90%). No stents were lo
st or damaged when retrieved after unsuccessful direct delivery. Eventually
, all stents could be implanted at the target site. Angiographic success (<
30% residual stenosis) was achieved in 49 lesions (96%). At 9 months, none
of the patients had died. Target lesion revascularization was necessary in
4 (8%) patients at 6 months and in 2 (4%) other patients between 6 and 9 m
onths. Minimal lumen diameter increased from 1.1 +/- 0.4 to 2.6 +/- 0.4 mm
(p < 0.001) after stent placement and 1.8 +/- 0.6 mm (p < 0.001) at 6 month
s follow-up. Angiographic restenosis (> 50%) at 6 months was present in 24%
of 49 treated stenoses. At 6 and 9 months, 39 (78%) and 41 (82%) of the pa
tients were free of anginal symptoms and the ischemic event free survival w
as 80% at 9 months. This study demonstrates the safety and efficacy of dire
ct placement of the JF stent as well as favorable clinical and angiographic
results up to 9 months after the procedure.